{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T02:46:29Z","timestamp":1782269189662,"version":"3.54.5"},"reference-count":20,"publisher":"Cambridge University Press (CUP)","issue":"12","license":[{"start":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T00:00:00Z","timestamp":1682294400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951123000380_as1\"><jats:title>Background:<\/jats:title><jats:p>Fontan baffle punctures and creation of Fontan fenestration for cardiac catheterisation procedures remain challenging especially due to the heavy calcification of prosthetic material and complex anatomy.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123000380_as2\"><jats:title>Objectives:<\/jats:title><jats:p>We sought to evaluate our experience using radiofrequency current via surgical electrocautery needle for Fontan baffle puncture to facilitate diagnostic, electrophysiology, and interventional procedures.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123000380_as3\"><jats:title>Methods:<\/jats:title><jats:p>A retrospective chart review of all Fontan patients (pts) who underwent Fontan baffle puncture using radiofrequency energy via surgical electrocautery from three centres were performed from January 2011 to July 2021.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123000380_as4\"><jats:title>Results:<\/jats:title><jats:p>A total of 19 pts underwent 22 successful Fontan baffle puncture. The median age and weight were 17 (3\u201336 years) and 55 (14\u201388) kg, respectively. The procedural indications for Fontan fenestration creation included: diagnostic study (n = 1), atrial septostomy and stenting (n = 1), electrophysiology study and ablation procedures (n = 8), Fontan baffle stenting for Fontan failure including protein-losing enteropathy (n = 7), and occlusion of veno-venous collaterals (n = 2) for cyanosis. The type of Fontan baffles included: extra-cardiac conduits (n = 12), lateral tunnel (n = 5), classic atrio-pulmonary connection (n = 1), and intra-cardiac baffle (n = 1). A Fontan baffle puncture was initially attempted using traditional method in 6 pts and Baylis radiofrequency trans-septal system in 2 pts unsuccessfully. In all pts, Fontan baffle puncture using radiofrequency energy via electrocautery needle was successful. The radiofrequency energy utilised was (10\u201350 W) and required 1\u20135 attempts for 2\u20135 seconds. There were no vascular or neurological complications.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123000380_as5\"><jats:title>Conclusions:<\/jats:title><jats:p>Radiofrequency current delivery using surgical electrocautery facilitates Fontan baffle puncture in patients with complex and calcified Fontan baffles for diagnostic, interventional, and electrophysiology procedures.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951123000380","type":"journal-article","created":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T10:46:12Z","timestamp":1682333172000},"page":"2621-2627","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["Extra-cardiac and complex Fontan baffle fenestration using radio frequency current via surgical electrocautery"],"prefix":"10.1017","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9653-0388","authenticated-orcid":false,"given":"Asra","family":"Khan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5992-568X","authenticated-orcid":false,"given":"Athar M.","family":"Qureshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish","family":"Bansal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Stapleton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa K.","family":"Webb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilson","family":"Lam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4425-1405","authenticated-orcid":false,"given":"Lindsay","family":"Eilers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harinder R.","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinath T.","family":"Gowda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,4,24]]},"reference":[{"key":"S1047951123000380_ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-020-00931-7"},{"key":"S1047951123000380_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2007.07.008"},{"key":"S1047951123000380_ref16","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.21453"},{"key":"S1047951123000380_ref10","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.26081"},{"key":"S1047951123000380_ref13","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.27202"},{"key":"S1047951123000380_ref19","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.111.968040"},{"key":"S1047951123000380_ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-015-1339-6"},{"key":"S1047951123000380_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)35562-X"},{"key":"S1047951123000380_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)35174-8"},{"key":"S1047951123000380_ref17","doi-asserted-by":"publisher","DOI":"10.1136\/heart.89.10.1227"},{"key":"S1047951123000380_ref1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.26.3.240"},{"key":"S1047951123000380_ref6","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951111001612"},{"key":"S1047951123000380_ref7","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.26042"},{"key":"S1047951123000380_ref8","doi-asserted-by":"publisher","DOI":"10.1002\/1522-726X(200008)50:4<434::AID-CCD14>3.0.CO;2-E"},{"key":"S1047951123000380_ref4","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2013.00045"},{"key":"S1047951123000380_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)40916-1"},{"key":"S1047951123000380_ref14","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12092"},{"key":"S1047951123000380_ref9","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20604"},{"key":"S1047951123000380_ref18","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20328"},{"key":"S1047951123000380_ref12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2011.03056.x"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951123000380","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T01:32:20Z","timestamp":1702431140000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951123000380\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,24]]},"references-count":20,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["S1047951123000380"],"URL":"https:\/\/doi.org\/10.1017\/s1047951123000380","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,24]]},"assertion":[{"value":"\u00a9 The 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