Creation of a transcatheter fenestration in children with failure of Fontan circulation: Focus on extracardiac conduit connection.

Catheter Cardiovasc Interv. 2015 Dec 1;86(7):1189-94. doi: 10.1002/ccd.26042. Epub 2015 Jun 29.

Creation of a transcatheter fenestration in children with failure of Fontan circulation: Focus on extracardiac conduit connection.

Rupp S1Schieke C1Kerst G1Mazhari N1Moysich A1Latus H1Michel-Behnke I2Akintuerk H1Schranz D1.

Comment by Konstantin Averin

Abstract

In this study, Takaya and colleagues investigate the impact of age on ASD closure in patients who are older than 50 years old (grouped into 3 groups by age at time of procedure: 50-59, 60-74 and >75 years old). The primary end point was all cause mortality and hospitalization due to heart failure or stroke. The study population consisted of 244 consecutive patients with 55 of the patients being older than 75. During a median follow up of 36 months, mortality and hospitalization due to heart failure or stroke occurred in 18 patients (7%). Kaplan-Meier analysis showed that the event-free survival rate was not different among the 3 age groups and that New York Heart Association functional class and right ventricular/left ventricular end-diastolic diameter ratio improved in patients older than 75 years of age, similar to the other age groups. The authors conclude that the long-term outcome in patients older than 75 years of age is not different from that in the other age groups and that functional capacity and cardiac remodeling improved in patients older than 75 years of age, similar to the other age groups. ASD closure can be considered a valuable therapeutic option in patients older than 75 years of age.