Transcatheter Closure of a Peripheral Arteriovenous Fistula: A Unique Use of a Covered Stent in a Child with Complex Congenital Heart Disease

Introduction. This report describes the use of a covered stent to occlude a surgical arteriovenous fistula in a child with complex cyanotic heart disease. Method. A single case report. Results. An Atrium iCAST covered stent was delivered percutaneously to the left axillary artery in an 8‐year‐old child with a failing single‐lung Fontan who had undergone the creation of a surgical axillary arteriovenous fistula to augment pulmonary blood flow. The covered stent completely occluded the fistula, without complications or compromise of arterial flow to the upper extremity. The patient subsequently experienced significant improvement in peripheral edema, ascites and pleural effusions. Conclusion. Although a single case report, this experience suggests a potentially important role for covered stents in the management of children with complex congenital heart disease.