DOI: 10.1161/circinterventions.124.014699 ISSN: 1941-7640

Transcatheter Interventions in Adults With Fontan Palliation

Eduardo Flores-Umanzor, Raquel Luna-López, Pedro Cepas-Guillen, Sílvia Montserrat, Bandar Alshehri, Rajesh Keshvara, Lusine Abrahamyan, Juan M. Carretero Bellón, Rafael Alonso-Gonzalez, Mark Osten, Xavier Freixa, Josep Rodes-Cabau, Lee Benson, Eric Horlick

The Fontan circuit is associated with chronically elevated systemic venous pressures and decreased cardiac output, often leading to circuit failure. Managing Fontan circuit failure is complex and requires multiple therapeutic options. Transcatheter interventions have emerged as a reliable approach. They can alleviate obstructions and improve cyanosis by enhancing pulmonary blood flow and oxygen saturation. These procedures can also increase cardiac output and reduce systemic venous pressure, contributing to patient stabilization. In addition, they help mitigate volume overload and decrease the risk of bleeding during heart or combined heart and liver transplants. In recent years, percutaneous interventions have rapidly evolved and become a key therapeutic option for addressing various aspects of Fontan circuit failure. These interventions should be considered integral to the management strategy for this specific patient population.

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