Fenestration closure after a Fontan operation in the heart catheterization labFFenestration closure after a Fontan operation in the heart catheterization labFenestration closure after a Fontan operation in the heart catheterization labEnglishCardiologyPreschooler (2-4 years);School age child (5-8 years)HeartHeart;Arteries;VeinsProceduresCaregivers Adult (19+)NA2009-11-06T05:00:00ZJackie Hubbert, BScN;Lee Benson, MD, FRCP(C), FACC, FSCAI;Carrie Morgan, RN, MN;Cindy Wasyliw, RN, BNSc6.0000000000000074.0000000000000939.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Read about fenestration closure after a Fontan operation, a surgery to close the hole between your child's heart and the tunnel that moves blood to the lungs.</p><h2>What is fenestration closure after a Fontan operation?</h2><p>Part of the Fontan operation involves making a tunnel to bring oxygen-poor blood directly from the body into the lungs. The tunnel connects the inferior vena cava to the pulmonary artery, bypassing the heart. It can be made in one of two ways:</p><ul><li>outside the heart (extracardiac conduit)</li><li>inside the heart (lateral tunnel)</li></ul><p>This new circulation can put extra pressure on the lungs while your child's body is getting used to it. To relieve this pressure, the surgeon makes a fenestration (hole) between the tunnel and the heart.</p><p>The fenestration allows some blood to flow from the tunnel into the heart. It acts as a temporary pressure release valve while your child's body is adjusting to the new circulation. It is usually closed several months after the Fontan operation, so that oxygen-poor and oxygen-rich blood no longer mix.</p><p>This information explains what happens when we close the hole. This procedure is done in the heart catheterization lab.</p> <figure> <span class="asset-image-title">Closing the fenestration after Fontan operation</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Fontan_fenestration_closure_MED_ILL_EN.jpg" alt="" /> <figcaption class="asset-image-caption">Closing the fenestration after the Fontan operation completes the separation of oxygen-rich blood from oxygen-poor blood. The illustration shows an extracardiac conduit to connect the inferior vena cava to the pulmonary artery.</figcaption> </figure> <h2>What is heart catheterization?</h2><p>During heart catheterization, the doctor carefully puts a long, thin tube called a catheter into a vein or artery in your child's neck or groin. The groin is the area at the top of the leg. Then, the catheter is threaded through the vein or artery to your child's heart.</p><p>The doctor who does the procedure is a cardiologist, which means a doctor who works on the heart and blood vessels. This may not be your child's regular cardiologist.</p><p>To learn about heart catheterization, please see <a href="/Article?contentid=59&language=English">Heart catheterization: Getting ready for the procedure</a>.</p><h2>Key points</h2> <ul> <li>Fenestration closure after a Fontan operation is a procedure to close the hole between your child's heart and the tunnel that takes oxygen-poor blood from the body to the lungs. </li> <li>The procedure is done in the heart catheterization lab. </li> <li>There is a small risk that your child will have complications from the procedure. Your child's doctor will explain the risks to you before the procedure. </li> <li>Your child will need to have an anaesthetic. Your child may need to stay overnight in the hospital after the procedure.</li> </ul><h2>What does the closure device look like and how does it stay in place?</h2> <p>The closure device is made of metal and mesh material. It looks like a short tube with different-sized discs (circles) on either end. Before it is put in, the discs are folded so the device will fit in the catheter. When it is in the right place, one disc opens up as the device is moved out of the catheter. The tube portion plugs the hole and the other disc opens up on the opposite side of the hole. </p> <h2>What happens during the fenestration closure</h2> <p>The procedure is performed while your child is under a general anaesthetic. This means that your child will be asleep during the procedure. </p> <p>During the procedure, the doctor inserts a catheter with a balloon on the tip into a blood vessel in the groin at the top of your child's leg. The catheter is moved up the blood vessel into the heart and into the fenestration. An X-ray picture is taken of the fenestration. </p> <p>The balloon is then inflated so that it fills the hole and closes it for a short time. This lets the doctor see if your child's heart is ready to have the closure device in place. If the pressure is good, the closure device is threaded through the catheter and placed into the fenestration. </p> <p>Once the device is in place, the doctor takes out the catheter and covers the cut on your child's leg with a bandage.</p> <h2>The procedure will take two to four hours</h2> <p>The procedure usually takes two to four hours. After the procedure, your child will go to the recovery room to wake up from the anaesthetic. If your child needs to stay overnight, they will be taken to the inpatient unit. If not, you can take your child home. </p><h2>After the procedure</h2> <p>The cardiologist will let you know when your child can go home. Your child will stay in the hospital for at least four to six hours after the procedure. Most children can go home on the same day as the procedure. </p> <p>If your child needs to stay overnight, they will be transferred to the inpatient unit.</p> <p>For information on what to do after your child goes home, please see <a href="/Article?contentid=1214&language=English">Heart catheterization: Caring for your child after the procedure</a>.</p>
Fermeture de fenestration après une opération de Fontan en laboratoire de cathétérisme cardiaqueFFermeture de fenestration après une opération de Fontan en laboratoire de cathétérisme cardiaqueFenestration closure after a fontan operation in the heart catheterization labFrenchCardiologyPreschooler (2-4 years);School age child (5-8 years)HeartHeart;Arteries;VeinsProceduresCaregivers Adult (19+)NA2009-11-06T05:00:00ZJackie Hubbert, BScN;Lee Benson, MD, FRCP(C), FACC, FSCAI;Carrie Morgan, RN, MN;Cindy Wasyliw, RN, BNSc6.0000000000000074.0000000000000939.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Lisez sur la fermeture de fenestration, une procédure qui vise à refermer le trou dans le cœur de votre enfant.</p><h2>Qu'est-ce qu'une fermeture de fenestration après une opération de Fontan?</h2> <p>Dans le cadre d'une opération de Fontan, il faut créer un tunnel pour acheminer le sang pauvre en oxygène directement du corps vers les poumons. Le tunnel relie la veine cave inférieure à l'artère pulmonaire en contournant le cœur. Cela peut être fait de deux façons : </p> <ul> <li>à l'extérieur du cœur (conduit extracardiaque), </li> <li>à l'intérieur du cœur (tunnel latéral). </li></ul> <p>Cette nouvelle circulation peut soumettre les poumons à une pression additionnelle jusqu'à ce que le corps de votre enfant s'y habitue. Pour soulager cette pression, le chirurgien pratique une fenestration (un trou) entre le tunnel et le cœur.</p> <p>La fenestration permet à une certaine quantité de sang de circuler du tunnel vers le cœur. Elle agit comme une soupape temporaire de surpression pendant que le corps de votre enfant s'ajuste à la nouvelle circulation sanguine. Cette fenestration est habituellement refermée quelques mois après l'opération de Fontan afin que le sang pauvre en oxygène et le sang riche en oxygène ne se mélangent plus. </p> <p>Le présent texte décrit ce qui se produit lorsqu'on referme la fenestration. Cette procédure est effectuée au laboratoire de cathétérisme cardiaque.</p> <figure> <span class="asset-image-title">Fermeture de la fenestration après une opération de Fontan <img src="https://assets.aboutkidshealth.ca/akhassets/Fontan_fenestration_closure_MED_ILL_FR.jpg" alt="" /> <figcaption class="asset-image-caption">La fermeture de la fenestration après une opération de Fontan complète la séparation du sang riche en oxygène et du sang faible en oxygène. L'illustration démontre un conduit extracardiaque qui sert à relier une veine cave inférieure à l'artère pulmonaire.</figcaption> </span></figure> <h2>Qu'est-ce que le cathétérisme cardiaque?</h2> <p>Pour effectuer un cathétérisme cardiaque, le médecin place soigneusement un long petit tube appelé cathéter dans une veine ou une artère de votre enfant au niveau de son cou ou de son aine. L'aine désigne la région en haut de la jambe. Ensuite, le cathéter est enfilé dans la veine ou l'artère jusqu'au cœur de votre enfant. </p> <p>Le médecin qui effectue l'intervention s'appelle un cardiologue, c'est-à-dire un médecin spécialiste du cœur et des vaisseaux sanguins. Il se peut qu'il ne s'agisse pas du cardiologue habituel de votre enfant. </p><h2>À retenir</h2> <ul> <li>Une fermeture de fenestration après une opération de Fontan est une intervention qui vise à refermer le trou entre le cœur de votre enfant et le tunnel qui achemine le sang pauvre en oxygène du corps vers les poumons. </li> <li>La procédure se fait dans un laboratoire de cathétérisme cardiaque. </li> <li>Il existe de faibles risques associés à l'intervention. Le médecin de votre enfant vous expliquera les risques avant la procédure. </li> <li>Votre enfant devra prendre un anesthésique. Votre enfant devra peut-être passer la nuit à l'hôpital après l'intervention. </li></ul><h2>À quoi ressemble le dispositif de fermeture et comment reste-t-il en place?</h2> <p>Le dispositif de fermeture se compose de métal et de filet. Il ressemble à un court tube avec des disques de tailles différentes à chaque extrémité. Avant d'être installé, les disques sont repliés pour que le dispositif puisse loger dans le cathéter. Une fois en place, un disque s'ouvre lorsque le dispositif est retiré du cathéter. La portion tubulaire bouche alors le trou et l'autre disque de l'autre côté du trou s'ouvre. </p> <h2>Que se passe-t-il lors d'une fermeture de fenestration</h2> <p>L'intervention se fait pendant que votre enfant est sous anesthésie générale. Cela signifie que votre enfant dormira pendant la procédure. </p> <p>Pendant l'intervention, le médecin insère un cathéter avec un ballon à l'extrémité dans un vaisseau sanguin dans l'aine en haut de la jambe de votre enfant. Le cathéter est ensuite acheminé dans le vaisseau sanguin jusqu'au cœur et à la fenestration. On prend alors une radiographie de la fenestration. </p> <p>Le ballon est alors gonflé pour qu'il remplisse le trou et le ferme pendant un court laps de temps. Cela permet au médecin de voir si le cœur de votre enfant est prêt à recevoir le dispositif de fermeture. Si la pression semble adéquate, le dispositif de fermeture est acheminé dans le cathéter et placé dans la fenestration. </p> <p>Une fois le dispositif en place, le médecin retire le cathéter et couvre l'incision sur la jambe de votre enfant d'un pansement.</p> <p>L'intervention dure habituellement de 2 à 4 heures. Après l'intervention, votre enfant devra aller en salle de réveil en attendant de se réveiller après l'anesthésie. Si votre enfant doit passer la nuit à l'hôpital, il sera reconduit à l'unité des patients hospitalisés. Sinon, vous pourrez ramener votre enfant à la maison. </p><h2>Après l'intervention</h2> <p>Le cardiologue vous indiquera le moment où votre enfant pourra retourner à la maison. Il devra probablement rester à l'hôpital au moins de 4 à 6 heures après l'intervention. La plupart des enfants peuvent renter à la maison le jour même de la procédure. </p> <p>Si votre enfant doit passer la nuit à l'hôpital, il sera transféré à l'unité des patients hospitalisés.</p> <p class="ms-rteCustom-InternalLinksParagraph"><span>Pour en savoir plus sur quoi faire une fois que votre enfant rentre à la maison, veuillez consulter la rubrique « <a href="/Article?contentid=1214&language=French">Cathéterisme cardiaque : Prendre soin de votre enfant après la procédure</a> ».</span></p><p></p>

 

 

Fenestration closure after a Fontan operation in the heart catheterization lab58.0000000000000Fenestration closure after a Fontan operation in the heart catheterization labFenestration closure after a Fontan operation in the heart catheterization labFEnglishCardiologyPreschooler (2-4 years);School age child (5-8 years)HeartHeart;Arteries;VeinsProceduresCaregivers Adult (19+)NA2009-11-06T05:00:00ZJackie Hubbert, BScN;Lee Benson, MD, FRCP(C), FACC, FSCAI;Carrie Morgan, RN, MN;Cindy Wasyliw, RN, BNSc6.0000000000000074.0000000000000939.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Read about fenestration closure after a Fontan operation, a surgery to close the hole between your child's heart and the tunnel that moves blood to the lungs.</p><h2>What is fenestration closure after a Fontan operation?</h2><p>Part of the Fontan operation involves making a tunnel to bring oxygen-poor blood directly from the body into the lungs. The tunnel connects the inferior vena cava to the pulmonary artery, bypassing the heart. It can be made in one of two ways:</p><ul><li>outside the heart (extracardiac conduit)</li><li>inside the heart (lateral tunnel)</li></ul><p>This new circulation can put extra pressure on the lungs while your child's body is getting used to it. To relieve this pressure, the surgeon makes a fenestration (hole) between the tunnel and the heart.</p><p>The fenestration allows some blood to flow from the tunnel into the heart. It acts as a temporary pressure release valve while your child's body is adjusting to the new circulation. It is usually closed several months after the Fontan operation, so that oxygen-poor and oxygen-rich blood no longer mix.</p><p>This information explains what happens when we close the hole. This procedure is done in the heart catheterization lab.</p> <figure> <span class="asset-image-title">Closing the fenestration after Fontan operation</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Fontan_fenestration_closure_MED_ILL_EN.jpg" alt="" /> <figcaption class="asset-image-caption">Closing the fenestration after the Fontan operation completes the separation of oxygen-rich blood from oxygen-poor blood. The illustration shows an extracardiac conduit to connect the inferior vena cava to the pulmonary artery.</figcaption> </figure> <h2>What is heart catheterization?</h2><p>During heart catheterization, the doctor carefully puts a long, thin tube called a catheter into a vein or artery in your child's neck or groin. The groin is the area at the top of the leg. Then, the catheter is threaded through the vein or artery to your child's heart.</p><p>The doctor who does the procedure is a cardiologist, which means a doctor who works on the heart and blood vessels. This may not be your child's regular cardiologist.</p><p>To learn about heart catheterization, please see <a href="/Article?contentid=59&language=English">Heart catheterization: Getting ready for the procedure</a>.</p><h2>Key points</h2> <ul> <li>Fenestration closure after a Fontan operation is a procedure to close the hole between your child's heart and the tunnel that takes oxygen-poor blood from the body to the lungs. </li> <li>The procedure is done in the heart catheterization lab. </li> <li>There is a small risk that your child will have complications from the procedure. Your child's doctor will explain the risks to you before the procedure. </li> <li>Your child will need to have an anaesthetic. Your child may need to stay overnight in the hospital after the procedure.</li> </ul><h2>Your child needs to take certain health precautions</h2> <h3>Antibiotics to prevent infectious endocarditis</h3> <p>Your child has been taking antibiotics before and after dental treatments and surgery. These drugs help prevent a heart infection called infectious endocarditis. Your child will still need to take these drugs after the fenestration closure. </p><h2>Coming back for a check-up</h2> <p>Your child will be given an appointment to see the cardiologist (heart specialist) six months to one year after the procedure. At that time, we will do tests to make sure that the hole is properly closed. </p> <p>Write the date and time of the appointment here:</p> <p> </p><h2>What does the closure device look like and how does it stay in place?</h2> <p>The closure device is made of metal and mesh material. It looks like a short tube with different-sized discs (circles) on either end. Before it is put in, the discs are folded so the device will fit in the catheter. When it is in the right place, one disc opens up as the device is moved out of the catheter. The tube portion plugs the hole and the other disc opens up on the opposite side of the hole. </p> <h2>What happens during the fenestration closure</h2> <p>The procedure is performed while your child is under a general anaesthetic. This means that your child will be asleep during the procedure. </p> <p>During the procedure, the doctor inserts a catheter with a balloon on the tip into a blood vessel in the groin at the top of your child's leg. The catheter is moved up the blood vessel into the heart and into the fenestration. An X-ray picture is taken of the fenestration. </p> <p>The balloon is then inflated so that it fills the hole and closes it for a short time. This lets the doctor see if your child's heart is ready to have the closure device in place. If the pressure is good, the closure device is threaded through the catheter and placed into the fenestration. </p> <p>Once the device is in place, the doctor takes out the catheter and covers the cut on your child's leg with a bandage.</p> <h2>The procedure will take two to four hours</h2> <p>The procedure usually takes two to four hours. After the procedure, your child will go to the recovery room to wake up from the anaesthetic. If your child needs to stay overnight, they will be taken to the inpatient unit. If not, you can take your child home. </p><h2>After the procedure</h2> <p>The cardiologist will let you know when your child can go home. Your child will stay in the hospital for at least four to six hours after the procedure. Most children can go home on the same day as the procedure. </p> <p>If your child needs to stay overnight, they will be transferred to the inpatient unit.</p> <p>For information on what to do after your child goes home, please see <a href="/Article?contentid=1214&language=English">Heart catheterization: Caring for your child after the procedure</a>.</p><h2>There are small risks of complications from the procedure</h2> <p>Generally, heart catheterization is a fairly low-risk procedure, but it is not risk-free. The doctor will explain the risks of heart catheterization to you in more detail before you give your consent for the procedure. The most common risks with fenestration closure are as follows: </p> <h3>The catheter may break through a blood vessel</h3> <p>There is a very small risk that the catheter may break through a blood vessel or the heart wall. To reduce this risk, we use a type of X-ray called fluoroscopy so we can see where the catheter is at all times. </p> <h3>Problems may occur with the closure device</h3> <p>While the device is being put in position, there is a risk that it may be put in the wrong place, move, or fall out of the fenestration. If this happens, the cardiologist will try to put it back in place. If this is not possible, surgery will be arranged to take out the device and close the fenestration. </p> <p>For general information about the risks of heart catheterization, please see <a href="/Article?contentid=59&language=English">Heart catheterization: Getting ready for the procedure</a>.</p>https://assets.aboutkidshealth.ca/akhassets/Fontan_fenestration_closure_MED_ILL_EN.jpgFenestration closure after a Fontan operation in the heart catheterization lab

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