Fenestrated Fontan
Fontan operation with intentional small opening to decompress systemic venous system.
Full Definition
A fenestrated Fontan is a modification of the standard Fontan operation that includes an intentional small opening (fenestration) between the systemic venous pathway and the systemic atrium. This 4-6 mm communication serves as a 'pop-off' valve during periods of elevated systemic venous pressure, allowing some deoxygenated blood to bypass the lungs and mix with oxygenated blood returning to the systemic circulation. While this results in mild cyanosis and reduced oxygen saturation, the fenestration provides hemodynamic benefits including improved cardiac output, reduced systemic venous pressure, and enhanced exercise tolerance. Many fenestrations close spontaneously over time, or can be closed electively via transcatheter device closure once the Fontan circulation has matured and adapted.
Usage
Usage note: Distinguish from unintended leaks or complications; fenestration is an intentional design feature.
In Context
- "The fenestrated Fontan allowed improved early postoperative hemodynamics despite mild desaturation." — Postoperative Note
- "Catheterization revealed a widely patent Fontan fenestration suitable for device closure." — Interventional Report