Fenestration
Pronunciation: fen-uh-STRAY-shuhn
A small, intentionally created hole or opening in a surgical repair, particularly in Fontan procedures to decompress the systemic venous system.
Full Definition
In congenital cardiac surgery, fenestration refers to a small, deliberately created opening or hole in a surgical repair or baffle. Most commonly associated with Fontan procedures, fenestrations provide a controlled communication between high-pressure and low-pressure systems, serving as a 'pop-off' mechanism during periods of elevated systemic venous pressure. The fenestration allows right-to-left shunting with mild cyanosis but prevents excessive systemic venous hypertension and its complications. Fenestrations may be created surgically or through transcatheter techniques and can often be closed electively once hemodynamics stabilize.
Usage
Usage note: Distinguish from unintended 'perforation' or 'leak'; fenestrations are intentional surgical features.
In Context
- "A 4mm fenestration was created in the Fontan baffle to reduce systemic venous pressure." — Operative report
- "Device closure of the fenestration was planned once hemodynamics stabilized." — Post-operative planning note