Fenestrated Completion
Completion of Fontan circulation with a small opening left in the baffle to allow right-to-left shunting.
Full Definition
Fenestrated completion refers to the final stage of Fontan circulation where a small opening (fenestration) is deliberately created in the Fontan baffle or conduit. This 4-5mm opening allows some systemic venous blood to bypass the pulmonary circulation and enter the systemic atrium, creating a right-to-left shunt. While this causes mild cyanosis, the fenestration serves as a 'pop-off' valve during periods of elevated Fontan pressures, maintaining cardiac output and reducing the risk of protein-losing enteropathy. The fenestration may close spontaneously or be closed electively via transcatheter techniques once Fontan pressures normalize.
Usage
Usage note: Always specify fenestration size and planned management strategy; distinguish from unintended baffle leaks.
In Context
- "The patient underwent fenestrated completion with a 4mm opening to optimize hemodynamics in the early post-operative period." — operative report
- "Catheterization demonstrated suitable hemodynamics for transcatheter fenestration closure two years after completion." — catheterization report