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Interact CardioVasc Thorac Surg 2009;9:55. doi:10.1510/icvts.2008.192229A
© 2009 European Association of Cardio-Thoracic Surgery
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Leo A. Bockeria
Ruben R. Movsesian
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eComment

eComment: Re: Do we need fenestration when performing two-staged total cavopulmonary connection using an extracardiac conduit?

Leo A. Bockeria and Ruben R. Movsesian

Bakoulev Scientific Center for Cardiovascular Surgery, 121552 Moscow, Russia

Do we need fenestration when performing two-staged total cavopulmonary connection using an extracardiac conduit?

The results of the Fontan operation depend on initial hemodynamic. In our opinion fenestration in Fontan circuit should not be a routine procedure. Some pharmacological agents reduce pulmonary vascular resistance thus decreasing venous pressure [1]. We agree with the necessity of fenestration after cardiopulmonary bypass in high-risk patients [2]. We believe that Fontan operation with complex concomitant intracardiac procedures and venous pressure higher than 18 mmHg in the postoperative period are indications for fenestration. Given results are based on a perfect surgical and pharmacological strategy and optimal indications to Fontan operation.


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  1. Harada Y, Uchita S, Sakamoto T, Kimura M, Umezu K, Takigiku K, Yasukouchi S. Do we need fenestration when performing two-stagedtotal cavopulmonary connection using an extracardiac conduit? Interact CardioVasc Thorac Surg 2009;9:50–55.[Abstract/Free Full Text]
  2. Airan B, Sharma R, Choudhary SK, Mohanty SR, Bhan A, Chowdhari UK, Juneja R, Kothari SS, Saxena A, Venugopal P. Univentricular repair: is routine fenestration justified? Ann Thorac Surg 2000;69:1900–1906.[Abstract/Free Full Text]

Related Article

Do we need fenestration when performing two-staged total cavopulmonary connection using an extracardiac conduit?
Yorikazu Harada, Shunji Uchita, Takahiko Sakamoto, Mitsuhiro Kimura, Kentaro Umezu, Kiyohiro Takigiku, and Satoshi Yasukouchi
Interactive CardioVascular and Thoracic Surgery 2009 9: 50-54. [Abstract] [Full Text] [PDF]




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Ruben R. Movsesian
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