A novel innominate vein-to-common atrium fenestration at Fontan completion.

With the hypothesis of low thromboembolic risk and higher late postoperative spontaneous closure, a new fenestration technique during extracardiac total cavopulmonary connection was attempted. From 2008 to 2009, 14 consecutive patients received an innominate vein-common atrium 5-mm Gore-Tex (W.L. Gore and Associates, Flagstaff, AZ) graft fenestration. Monitoring was performed by contrast bubble echocardiography at hospital discharge and up to 6 months postoperatively. The technique proved safe and reproducible, did not add to surgical difficulty or time, and provided reliable fenestration of up to at least 3 weeks, with a high rate of spontaneous closure during intermediate follow-up.