Percutaneous closure of fistula between pulmonary trunk and Fontan circulation. How would I approach it?

HOW WOULD I APPROACH IT? There is no doubt that, procedurally, the case of fistulization reported between the pulmonary artery trunk and the right pulmonary branch is an interesting case similar to common situations reported in the routine clinical practice where pulmonary trunk surgical ligation is...

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Main Author: Pedro Betrián Blasco
Format: Article
Language:English
Published: Permanyer 2022-11-01
Series:REC: Interventional Cardiology (English Ed.)
Online Access:https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=912
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author Pedro Betrián Blasco
author_facet Pedro Betrián Blasco
author_sort Pedro Betrián Blasco
collection DOAJ
description HOW WOULD I APPROACH IT? There is no doubt that, procedurally, the case of fistulization reported between the pulmonary artery trunk and the right pulmonary branch is an interesting case similar to common situations reported in the routine clinical practice where pulmonary trunk surgical ligation is not complete thus leaving residual passage between the heart and Fontan circulation. This is unsought because it sends already oxygenated blood back to the lung, which overloads a circulation so sensitive as the Fontan one that lacks heart pump and works through venous pressure gradient. In this type of procedures, closing the junction between the branch and the pulmonary trunk is often enough. Different strategies exist for this purpose. First, we need to think about the approach that should be used to close the defect. In this case, although the existence of fenestration (communication between Fontan circulation and the systemic atrial region) facilitates occlusion using the antegrade (through the ventricle) and retrograde (coming from the pulmonary artery) approaches, the latter is often easier and faster to use. Procedure can be performed via femoral access. The bigger the patient the easier the procedure. However, in very small patients, it is often easier to perform via jugular access...
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spelling doaj.art-53285ba2831d469780ac7968ba53a4982022-12-22T03:35:26ZengPermanyerREC: Interventional Cardiology (English Ed.)2604-73222022-11-014434334810.24875/RECICE.M22000301Percutaneous closure of fistula between pulmonary trunk and Fontan circulation. How would I approach it?Pedro Betrián Blasco0Unidad de Hemodinámica Pediátrica, Servicio de Cardiología Pediátrica, Hospital Universitario Valle de Hebrón, Barcelona, SpainHOW WOULD I APPROACH IT? There is no doubt that, procedurally, the case of fistulization reported between the pulmonary artery trunk and the right pulmonary branch is an interesting case similar to common situations reported in the routine clinical practice where pulmonary trunk surgical ligation is not complete thus leaving residual passage between the heart and Fontan circulation. This is unsought because it sends already oxygenated blood back to the lung, which overloads a circulation so sensitive as the Fontan one that lacks heart pump and works through venous pressure gradient. In this type of procedures, closing the junction between the branch and the pulmonary trunk is often enough. Different strategies exist for this purpose. First, we need to think about the approach that should be used to close the defect. In this case, although the existence of fenestration (communication between Fontan circulation and the systemic atrial region) facilitates occlusion using the antegrade (through the ventricle) and retrograde (coming from the pulmonary artery) approaches, the latter is often easier and faster to use. Procedure can be performed via femoral access. The bigger the patient the easier the procedure. However, in very small patients, it is often easier to perform via jugular access...https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=912
spellingShingle Pedro Betrián Blasco
Percutaneous closure of fistula between pulmonary trunk and Fontan circulation. How would I approach it?
REC: Interventional Cardiology (English Ed.)
title Percutaneous closure of fistula between pulmonary trunk and Fontan circulation. How would I approach it?
title_full Percutaneous closure of fistula between pulmonary trunk and Fontan circulation. How would I approach it?
title_fullStr Percutaneous closure of fistula between pulmonary trunk and Fontan circulation. How would I approach it?
title_full_unstemmed Percutaneous closure of fistula between pulmonary trunk and Fontan circulation. How would I approach it?
title_short Percutaneous closure of fistula between pulmonary trunk and Fontan circulation. How would I approach it?
title_sort percutaneous closure of fistula between pulmonary trunk and fontan circulation how would i approach it
url https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=912
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