fenestration
Pronunciation: fen-uh-STRAY-shun
A surgically created small opening in the Fontan baffle to decompress the single ventricle at the expense of mild cyanosis.
Full Definition
Fenestration in pediatric cardiac surgery refers to a small, controlled communication created in the Fontan baffle during completion of single ventricle palliation. This technique creates a 'pop-off' mechanism that allows some deoxygenated blood to return directly to the systemic ventricle, reducing venous pressures and improving cardiac output during the early postoperative period. While fenestration results in mild arterial desaturation and cyanosis, it significantly reduces the risk of complications such as prolonged pleural effusions, low cardiac output, and arrhythmias. The fenestration often closes spontaneously over time or can be closed electively with a transcatheter device when the patient demonstrates stable hemodynamics.
Usage
Usage note: Specific to Fontan circulation when used in pediatric cardiology; distinguish from fenestration in other surgical contexts.
In Context
- "The patient underwent fenestrated Fontan completion with a 4mm opening in the lateral tunnel." — Operative report
- "Transcatheter closure of the Fontan fenestration was performed two years post-operatively." — Interventional procedure note