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Figure 2: A large fenestration (single arrow) leads to the right-to-left shunt from an extracardiac conduit Fontan circuit (a) shown by a conduit angiogram in the anteroposterior view. Previously placed devices in the levoatriocardinal vein and coils in aortopulmonary collaterals are seen. Following the reduction of fenestration with atrial flow regulator device (double arrow), conduit angiogram (b) demonstrates reduced right-to-left shunt. A magnified enface view (c) compares the lumen of the orifice of atrial flow regulator (dotted arrow) with a 5 Fr pigtail placed within the conduit

Figure 2:  A  large fenestration (single arrow) leads to the right-to-left shunt from an extracardiac conduit Fontan circuit (a) shown by a conduit angiogram in the anteroposterior view. Previously placed devices in the levoatriocardinal vein and coils in aortopulmonary collaterals are seen. Following the reduction of fenestration with atrial flow regulator device (double arrow), conduit angiogram (b) demonstrates reduced right-to-left shunt. A magnified <b>enface</b> view (c) compares the lumen of the orifice of atrial flow regulator (dotted arrow) with a 5 Fr pigtail placed within the conduit