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Extracardiac Fontan Stenting

Date: Oct 9, 2023

Question:

I have abbreviated the report to submit... Right heart catheterization was performed. Left heart catheterization was performed. Conduit angiography was performed. A super-stiff wire was navigated into the innominate vein. The 8-French venous sheath was exchanged for a 14-French x 65 cm Gore Dry Seal Flex sheath. A 5-French MultiTrack catheter was advanced into the conduit. Using the Medrad Power Injector, angiography was performed. Again, the conduit was seen to be diffusely small with a focal narrowing in the middle (possibly at the site of a previous fenestration). I proceeded to conduit stenting. The following stents were placed in the conduit: P4010 x 2 P5010 x 2 These stents were post-dilated with 18, 20, 22, and eventually a 24 mm high-pressure balloon up to rated burst pressure. The conduit appeared significantly larger. Final angiography showed patent stents with no extravasation. Report states this as an Extra-cardiac Fontan with 18 mm Gore-Tex conduit performed 20+ years ago. Recommended codes? 33745? 37236 and RHC/LHC?

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