{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T02:46:30Z","timestamp":1782269190578,"version":"3.54.5"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,6,29]],"date-time":"2015-06-29T00:00:00Z","timestamp":1435536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We report our experience with a transcatheter technique to bypass the lung and to thus improve single\u2010ventricle preload and reduce venous congestion in Fontan patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>In the absence of a dedicated power source to serve the pulmonary circulation and a significantly elevated transpulmonary pressure gradient, fenestration of the Fontan circulation is an option to improve hemodynamics in patients by relieving excessive systemic venous pressure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>From 2005 to 2011, 22 transcatheter fenestrations were performed without any major complications in 19 patients (median age 3.2 years, interquartile range (IQR) 2.7\u20133.7 years)) with failing Fontan circulation and exceeding systemic venous pressure. In 16 patients, the procedure was performed for acute postoperative failure 1\u201324 days after surgery. After perforation of the conduit and atrial wall by a Brockenbrough needle and gradual balloon dilation, premounted stents were expanded to create a diabolo configuration with flaring stent edges, leaving a slight but definitive central waist. The procedure resulted in regression of pleural effusions and a significant decrease in systemic venous pressure. Clinical improvement was observed in 16 of the 19 treated patients. Follow\u2010up demonstrated sustained fenestration in 85% of treated patients for at least 24 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Transcatheter creation of a Fontan fenestration is a safe approach despite the anatomic gap between the extracardiac conduit cavity and the atrial wall. Stent implantation allows defining the diameter of the fenestration, reduces spontaneous occlusion, and ensures sustained clinical improvement. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.26042","type":"journal-article","created":{"date-parts":[[2015,6,29]],"date-time":"2015-06-29T07:44:10Z","timestamp":1435563850000},"page":"1189-1194","source":"Crossref","is-referenced-by-count":26,"title":["Creation of a transcatheter fenestration in children with failure of fontan circulation: Focus on extracardiac conduit connection"],"prefix":"10.1002","volume":"86","author":[{"given":"Stefan","family":"Rupp","sequence":"first","affiliation":[{"name":"Pediatric Heart Center, University of Giessen and Marburg Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christin","family":"Schieke","sequence":"additional","affiliation":[{"name":"Pediatric Heart Center, University of Giessen and Marburg Giessen 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