Late recognition and transcatheter closure of ventriculopulmonary artery shunts in Fontan patients

In Fontan patients, the persistence of ventriculopulmonary flow is known to cause Fontan circuit pressure elevation and early failure (1, 2). Recognizing this issue can be challenging, until the failure is heralded. Early closure of the shunt may restore the hemodynamics. Here we describe the natural history of untreated ventriculopulmonary shunts in the circulation and the clinical benefits derived from transcatheter closure.