fenestration closure
Procedure to close the intentional hole created in a Fontan baffle, typically performed months to years after initial surgery.
Full Definition
Fenestration closure involves sealing the planned communication between the Fontan conduit and the atrium that was created during the initial Fontan operation. The fenestration serves as a 'pop-off' valve in the early postoperative period, allowing some right-to-left shunting to maintain cardiac output if pulmonary vascular resistance is elevated. Once the patient has adapted to Fontan physiology and demonstrates stable hemodynamics, the fenestration can be closed percutaneously with occluder devices or surgically. Closure eliminates cyanosis and reduces the long-term risk of paradoxical embolism and brain abscess.
Usage
Usage note: Distinguish from initial fenestration creation, which occurs during the Fontan operation itself.
In Context
- "The patient underwent successful transcatheter fenestration closure six months after Fontan completion." — procedure note
- "Fenestration closure resulted in improved oxygen saturations from 88% to 96%." — follow-up note