Despite advancements in postoperative outcomes after Fontan surgery, there remains a risk of suboptimal outcomes and significant morbidity in the early postoperative period. Anatomical obstructions in the Fontan pathway can lead to prolonged pleural effusion or ascites, cyanosis, and low cardiac output syndrome (LCOS). Transcatheter interventions offer an alternative to early re-surgery for treating these complications. Over a 13-year period, early catheter angiography, performed within 30 days post-index procedure, was administered to 41 patients, identifying anatomical issues that necessitated re-intervention in 39 cases. This led to transcatheter interventions in 37 (10.4%) of the 344 Fontan surgery patients. The median age was 4.8 years (IQR: 4–9.4), and the median weight was 16.5 kg (IQR: 15–25.2), with females comprising 51.4% (19/37) of this group. The primary indications for the procedures were persistent pleural effusion or ascites in 27 patients (66%), LCOS in 8 patients (20%), and cyanosis in 6 patients (14%). Among the 37 undergoing transcatheter intervention, 30 were treated solely with this method and discharged, three died in ICU follow-up, and four required early re-surgery. No procedural mortality was observed. Our findings demonstrate that transcatheter interventions, including stent implantation, balloon angioplasty, and fenestration dilation, are safe and effective in the early post-Fontan period. Therefore, they should be considered an integral part of the management strategy for this patient group.

尽管 Fontan 手术后术后结果取得了进步，但术后早期仍然存在结果不理想和显着发病率的风险。 Fontan 通路的解剖学阻塞可导致长期胸腔积液或腹水、发绀和低心输出量综合征 (LCOS)。经导管干预为治疗这些并发症提供了早期再次手术的替代方案。在 13 年的时间里，对 41 名患者进行了手术后 30 天内进行的早期导管血管造影，发现了 39 例患者存在需要重新干预的解剖问题。这导致 344 名 Fontan 手术患者中的 37 名 (10.4%) 接受了经导管干预。中位年龄为 4.8 岁（IQR：4-9.4），中位体重为 16.5 kg（IQR：15-25.2），其中女性占该组的 51.4%（19/37）。手术的主要适应症是 27 名患者 (66%) 出现持续性胸腔积液或腹水，8 名患者 (20%) 出现 LCOS，6 名患者 (14%) 出现紫绀。 37例接受经导管介入治疗的患者中，30例仅采用该方法治疗并出院，3例在ICU随访中死亡，4例需要早期再次手术。没有观察到手术死亡。我们的研究结果表明，经导管干预措施，包括支架植入、球囊血管成形术和开窗扩张术，在 Fontan 后早期是安全有效的。因此，它们应被视为该患者群体管理策略的一个组成部分。