Momenah Tarek S, Eltayb Haifa, Oakley Reida El, Qethamy Howeida Al, Faraidi Yahya Al
Prince Sultan Cardiac Center, P.O. Box 7897, Riyadh, 1159, Kingdom of Saudi Arabia,
Pediatr Cardiol. 2008 May;29(3):585-8. doi: 10.1007/s00246-007-9154-3. Epub 2007 Dec 11.
Baffle fenestration is associated with a significantly better outcome in standard and high-risk patients undergoing completion of Fontan. We report the effects of subsequent transcatheter closure of fenestration on exercise capacity and oxygen saturation. Sixteen patients with a mean age of 10.3 years underwent Amplatzer septal occluder (ASO) device transcatheter closure of Fontan fenestration. All had a fenestrated Fontan operation 6 month to 8 years prior to the procedure. A stress test was performed before and after device closure of fenestration in 14 patients (2 patients did not tolerate stress test before the procedure). The fenestrations in all patients were successfully occluded with the use of the Amplatzer device occluder. No complications occurred during or after the procedure. O2 saturation increased from a mean 85.1 +/- 7.89% to 94.5 +/- 3.63% (p < 0.01) at rest and from 66.2 +/- 12.86% to 87.2 +/- 8.64% (p < 0.01) following exercise. Exercise duration has also increased from 8.22 +/- 2.74 min to 10.29 +/- 1.91 min (p < 0.05). Transcatheter closure of Fontan fenestration increases the duration of exercise capacity and increases O2 saturation at rest and after exercise.
在接受Fontan手术完成的标准风险和高风险患者中，心房内分流孔开窗与显著更好的预后相关。我们报告了随后经导管闭合分流孔对运动能力和血氧饱和度的影响。16例平均年龄为10.3岁的患者接受了经导管使用Amplatzer房间隔封堵器（ASO）闭合Fontan分流孔。所有患者在手术前6个月至8年都接受了开窗Fontan手术。14例患者在分流孔封堵器闭合前后进行了压力测试（2例患者在手术前无法耐受压力测试）。所有患者的分流孔均成功使用Amplatzer封堵器闭合。手术期间或术后均未发生并发症。静息时血氧饱和度从平均85.1±7.89%升至94.5±3.63%（p<0.01），运动后从66.2±12.86%升至87.2±8.64%（p<0.01）。运动持续时间也从8.22±2.74分钟增加到10.29±1.91分钟（p<0.05）。经导管闭合Fontan分流孔可增加运动能力持续时间，并提高静息和运动后的血氧饱和度。
