Interventional catheterization in pediatric patients after Fontan procedure

To the Editor, The advances made in surgical techniques followed by the best candidate selection process possible and optimal preparation of patients eligible for surgery have contributed to reducing early postoperative mortality in patients treated with the Fontan procedure.1 However, the balance provided by the Fontan procedure is precarious and can fail for multiple reasons that can be resolved through interventional catheterizations (IC).2-4 This study describes the experience of our center performing IC and focuses on the type of interventional procedures performed and predictors of these. We conducted a retrospective study of all patients < 18 years-old who underwent a Fontan procedure from January 2000 through December 2021 and were treated with IC due to suspected anatomical injury detected by echocardiography (annually) or magnetic resonance imaging (at 10 years and then every 3 years) or complications like protein-losing enteropathy, plastic bronchitis or hepatopathy. Since 2017, scheduled catheterizations are performed 10 years after the Fontan procedure. All patients gave their prior written informed consent, and the study was approved by the hospital ethics committee. Possible sex and gender variables have been considered in accordance with the SAGER guidelines. Descriptive statistics of the demographic, anatomical, hemodynamic, and surgical variables was used. Normally distributed variables were expressed as...