{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T08:01:57Z","timestamp":1781078517299,"version":"3.54.1"},"reference-count":7,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>A 40-year-old man with complex congenital heart disease (double-inlet left ventricle with transposition of the great arteries), previously treated with a Blalock\u2013Taussig shunt in infancy and a modified Fontan procedure (including superior vena cava-to-pulmonary artery anastomosis, atriopulmonary connection, and tricuspid valve closure with a Dacron patch), presented to the emergency department with worsening dyspnea and hypoxemia (SpO2 &lt; 80%). Echocardiography suggested a shunt through the tricuspid patch, possibly related to prior atrial flutter ablation. Cardiac catheterization confirmed an approximately 10 mm fenestration in the calcified patch causing a significant bidirectional shunt, along with two fistulae between the innominate vein and the left atrium. The fenestration was successfully closed using a septal occluder via right femoral venous access under transesophageal echocardiographic guidance. The venous collaterals were occluded with vascular plugs via right femoral and left brachial approaches. Technical success of the closure of the intracardiac and the venous shunts was confirmed angiographically at the end of the procedure. Oxygen saturation improved immediately from 72% to 91% and remained stable at the 2-year follow-up. Similarly, NYHA functional class improved from IV to II and episodes of tachycardia became less frequent and better tolerated, with sustained benefit throughout follow-up.<\/jats:p>","DOI":"10.3390\/jcdd13060257","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:33:44Z","timestamp":1781073224000},"page":"257","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Concomitant Intracardiac Shunt and Venous Collaterals After Fontan Procedure: A Case Report of Percutaneous Management"],"prefix":"10.3390","volume":"13","author":[{"given":"Georgiana","family":"Pintea Bentea","sequence":"first","affiliation":[{"name":"Department of Cardiology, CHU UCL Namur Sainte Elisabeth, 5000 Namur, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1487-6583","authenticated-orcid":false,"given":"Marielle","family":"Morissens","sequence":"additional","affiliation":[{"name":"Department of Cardiology, CHU Brugmann, 1020 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Emmanuel","family":"Massart","sequence":"additional","affiliation":[{"name":"Department of Cardiology, CHU UCL Namur Sainte Elisabeth, 5000 Namur, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6203-8229","authenticated-orcid":false,"given":"Jose","family":"Castro Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, CHU Brugmann, 1020 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"ref_1","first-page":"I157","article-title":"The Fontan procedure: Contemporary techniques have improved long-term outcomes","volume":"116","author":"Iyengar","year":"2007","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Jalal, Z., Gewillig, M., Boudjemline, Y., Gu\u00e9rin, P., Pilati, M., Butera, G., Malekzadeh-Milani, S., Avesani, M., and Thambo, J.B. (2022). Transcatheter interventions in patients with a Fontan circulation: Current practice and future developments. Front. Pediatr., 10.","DOI":"10.3389\/fped.2022.965989"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"i7","DOI":"10.1093\/eurheartjsupp\/suaf088","article-title":"The fate of the Fontan circulation","volume":"28","author":"Barracano","year":"2026","journal-title":"Eur. Heart J. Suppl."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1017\/S1047951103000908","article-title":"Characterization and treatment of systemic venous to pulmonary venous collaterals seen after the Fontan operation","volume":"13","author":"Sugiyama","year":"2003","journal-title":"Cardiol. Young"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.ijcard.2015.04.065","article-title":"Systemic to pulmonary venous collaterals in adults with single ventricle physiology after cavopulmonary palliation","volume":"189","author":"Lluri","year":"2015","journal-title":"Int. J. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"E230","DOI":"10.1111\/chd.12276","article-title":"Embolization of veno-venous collaterals after the Fontan operation is associated with decreased survival","volume":"10","author":"Poterucha","year":"2015","journal-title":"Congenit. Heart Dis."},{"key":"ref_7","first-page":"100479","article-title":"Percutaneous closure of veno-venous collaterals in adult Fontan patients: A single-centre experience and systematic review","volume":"14","author":"Nederend","year":"2023","journal-title":"Int. J. Cardiol. Congenit. Heart Dis."}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/6\/257\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T07:30:20Z","timestamp":1781076620000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/6\/257"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,10]]},"references-count":7,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["jcdd13060257"],"URL":"https:\/\/doi.org\/10.3390\/jcdd13060257","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,10]]}}}