Systemic venous collateral channel causing desaturation after bidirectional cavopulmonary anastomosis: percutaneous closure

2010 ◽  
Vol 21 (1) ◽  
pp. 107-109 ◽  
Author(s):  
Satish Karur ◽  
Jayaranganath Mahima ◽  
Manjunath Cholenahally Nanjappa
Keyword(s):  
Vascular Plug ◽  
Caval Vein ◽  
Excellent Outcome ◽  
Bidirectional Glenn ◽  
Inferior Caval Vein ◽  
Bidirectional Glenn Shunt ◽  
Cavopulmonary Anastomosis ◽  
Bidirectional Cavopulmonary Anastomosis ◽  
Collateral Channel ◽  
Cavopulmonary Shunt

AbstractAn infant with cyanotic cardiac disease that was palliated with a bidirectional cavopulmonary shunt developed progressive and worsening cyanosis 5 years after the surgical procedure. A large venous collateral was found to be decompressing the bidirectional Glenn shunt from the superior caval vein to the inferior caval vein and was percutaneously closed with a vascular plug. The unusually large venous collateral, and the excellent outcome associated with percutaneous procedure are discussed.

scholarly journals Post-Glenn Shunt Systemic Desaturation—Is Venovenous Collateral the Culprit?

2020 ◽  
Vol 5 (02) ◽  
pp. 123-128
Author(s):  
Hemanth Harish Ponnana ◽  
Jyotsna Maddury ◽  
M. Naveen Kumar
Keyword(s):  
Case Reports ◽  
Glenn Shunt ◽  
Bidirectional Glenn ◽  
Bidirectional Glenn Shunt ◽  
Cavopulmonary Anastomosis ◽  
Bidirectional Cavopulmonary Anastomosis

AbstractAfter classic Glenn shunt or bidirectional cavopulmonary anastomosis, the reappearance or deepening of cyanosis may be due to systemic venous collateral channels. There are only few case reports on this issue in the present literature. Here, we present two cases that underwent bidirectional Glenn shunt, who later presented with cyanosis and desaturation and both of them were found to have venovenous collaterals.

Haemodynamic consequences following closure of an Abernethy malformation in a patient following a total cavopulmonary shunt

2018 ◽  
Vol 28 (5) ◽  
pp. 768-770 ◽  
Author(s):  
Deepa Sasikumar ◽  
Bijulal Sasidharan ◽  
Anoop Ayyappan
Keyword(s):  
Septal Defect ◽  
Pulmonary Stenosis ◽  
Vascular Plug ◽  
Caval Vein ◽  
Abernethy Malformation ◽  
Inferior Caval Vein ◽  
Hypoplastic Right Ventricle ◽  
Situs Ambiguous ◽  
Cavopulmonary Shunt ◽  
Kawashima Operation

AbstractA 17-year-old girl with situs ambiguous, hypoplastic right ventricle with a large ventricular septal defect, and severe pulmonary stenosis had undergone Kawashima operation 10 years back. She had significant desaturation because of a large Abernethy malformation, with reverse shunting from the inferior caval vein to the portal vein. It was closed with a vascular plug, with improvement in oxygen saturation. She developed extensive inferior caval vein thrombus following the procedure, which was managed conservatively by anti-coagulation.

Transcatheter closure of Abernethy malformation associated with interrupted inferior caval vein and other systemic venous anomalies

2021 ◽  
pp. 1-3
Author(s):  
Samir Shakya ◽  
Anita Saxena ◽  
Sivasubramanian Ramakrishnan
Keyword(s):  
Pulmonary Hypertension ◽  
Transcatheter Closure ◽  
Rare Entity ◽  
Severe Pulmonary Hypertension ◽  
Device Closure ◽  
Venous Anatomy ◽  
Vascular Plug ◽  
Caval Vein ◽  
Abernethy Malformation ◽  
Inferior Caval Vein

Abstract Abernethy malformation is a rare entity. We report a 5-year-old boy presenting with severe pulmonary hypertension in whom Abernethy malformation and inferior caval vein interruption were diagnosed by CT angiography. In addition, the iliac veins were thrombosed with multiple venous collateral drainage. This abnormal venous anatomy caused difficulty in device closure of the Abernethy malformation, which was successfully closed using a vascular plug.

the clinical impact of antegrade pulmonary blood flow on the bidirectional cavopulmonary shunt in infants

2004 ◽  
Vol 14 (S3) ◽  
pp. 44-47 ◽  
Author(s):  
lucia migliazza ◽  
francesco seddio ◽  
francesco paolo annecchino ◽  
giancarlo crupi
Keyword(s):  
Blood Flow ◽  
Pulmonary Blood Flow ◽  
Ventricular Dysfunction ◽  
Fontan Procedure ◽  
Volume Overload ◽  
Clinical Impact ◽  
Cavopulmonary Anastomosis ◽  
Alternative Sources ◽  
Bidirectional Cavopulmonary Anastomosis ◽  
Cavopulmonary Shunt

the bidirectional cavopulmonary anastomosis is commonly used in the palliation of patients with a functionally univentricular physiology. the management of alternative sources of flow of blood to the lungs, as well as the magnitude of acceptable accessory blood flow at the time of surgery, nonetheless, remains controversial. these issues are particularly significant when a cavopulmonary anastomosis is performed in infants who may become candidates for a fontan procedure. indeed, a long-standing volume overload, which is invariably associated with the maintenance of accessory sources of pulmonary blood flow, may result in systemic ventricular dysfunction. these observations prompted us to review the influence of antegrade pulmonary blood flow in the management of infants undergoing a cavopulmonary anastomosis.

scholarly journals In Hospital Outcomes after Bidirectional Cavopulmonary Anastomosis: 18 Year Experience from a Single Center

2020 ◽  
Vol 17 (2) ◽  
pp. 13-19
Author(s):  
Raamesh Koirala ◽  
Nirmal Panthee ◽  
Sidhartha Pradhan ◽  
Nivesh Rajbhandari ◽  
Daman Kiran Shrestha ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Double Outlet Right Ventricle ◽  
Single Center ◽  
Hospital Records ◽  
Cardiac Lesion ◽  
First Case ◽  
Cavopulmonary Anastomosis ◽  
Cardiac Lesions ◽  
Bidirectional Cavopulmonary Anastomosis ◽  
Cavopulmonary Shunt

Background: Bidirectional cavopulmonary shunt (BCPS) is used for the interim palliation of a variety of cyanotic cardiac lesions. It is a standard palliative step for patients with functionally univentricular hearts in hope of achieving Fontan completion. At our center, first case of BCPS was performed on February 7, 2002. Here, we share our experience with BCPS over last 18 years. Methods: This is a retrospective analysis of all patients undergoing BCPS from February 2002 to July 2019. Patients who underwent BCPS as a part of one-and-half ventricular repair for Ebstein’s anomaly were excluded. Baseline, intraoperative, and postoperative variables were collected from hospital records. Results: A total of 326 patients with mean age of 5.7±5.8 years (median 3.5 years; range: 1.5 months-32 years) underwent BCPS over last 18 years. Majority (61%) were males. Double outlet right ventricle (DORV) was the most common primary cardiac lesion (30%) followed by tricuspid atresia (23%). Mean ICU stay was 3.9±4.8 days, with hospital stay of 7.8±5.9 days. In-hospital mortality was 15%. Patients who died had low body weight (11.8±10.7 kg vs 16.0±11.6 kg; p=0.019), and longer cardiopulmonary bypass time (101±64 min vs 76±42 min; p=0.001). Oxygen saturation improved significantly at the time of discharge (79.2±9.5% vs 68.6±13.7%; p=0.000). Conclusion: This is the first report of its kind to analyze the outcomes of BCPS in our center. We have discussed the evolution of BCPS surgery in our center and presented our outcomes. Our in-hospital mortality remains high, and we need to strive towards reducing the mortality.

Results of Additional Pulsatile Pulmonary Blood Flow with Bidirectional Glenn Cavopulmonary Anastomosis: Positive Effect on Main Pulmonary Artery Growth and Less Need for Fontan Conversion

2013 ◽  
Vol 16 (1) ◽  
pp. 30 ◽  
Author(s):  
Orhan Saim Demirtürk ◽  
Murat Güvener ◽  
İsa Coşkun ◽  
Selman Vefa Yıldırım
Keyword(s):  
Blood Flow ◽  
Pulmonary Artery ◽  
Oxygen Pressure ◽  
Pulmonary Blood Flow ◽  
Main Pulmonary Artery ◽  
Bidirectional Glenn ◽  
Cavopulmonary Anastomosis ◽  
Cavopulmonary Shunt ◽  
Partial Oxygen

<strong>Background</strong>: Additional antegrade pulsatile pulmonary blood flow obtained by leaving the main pulmonary artery patent during bidirectional cavopulmonary shunt has been shown to give additional benefits to the bidirectional Glenn cavopulmonary anastomosis. We retrospectively evaluated our 20-patient pulsatile Glenn series in order to find out whether these salutary effects were valid or not.<br /><strong>Methods</strong>: Between June 2007 and November 2011, 20 patients (11 girls and 9 boys) with single-ventricle physiology underwent bidirectional cavopulmonary anastomosis. The additional source of blood flow was through the unligated main pulmonary artery in all patients. A retrospective review of our surgical experience was performed focusing on the role of additional pulmonary flow. Medical records and perioperational and postoperative follow-up data including clinical outcomes were retrospectively retrieved and analyzed.<br /><strong>Results</strong>: Two patients died in the early postoperative period. One patient died in the follow-up period. Mean follow-up time was 23.9 ± 15.7 months. No superior vena cava syndrome and no increase in pulmonary vascular resistance were observed. Improvement of partial oxygen pressure after pulsatile Glenn has been shown in all patients (P = .00). At a mean interval of 22.9 months, main pulmonary artery size continued to increase after pulsatile Glenn cavopulmonary anastomosis (P = .028). Only 1 patient was converted to Fontan type circulation after pulsatile Glenn cavopulmonary anastomosis.<br /><strong>Conclusions</strong>: The pulsatile cavopulmonary shunt is a useful procedure in the early and intermediate term management of patients with a functional univentricular heart. It improves partial oxygen pressure and the impact of pulsatility on the main pulmonary artery.

scholarly journals Superior Cavopulmonary Anastomosis in Patients With Bilateral Superior Caval Veins: Use of a Rolled Pericardial Graft to Create a Single Caval Vein

2018 ◽  
Vol 9 (4) ◽  
pp. 446-450 ◽  
Author(s):  
Tran-Thuy Nguyen ◽  
Ngoc-Thanh Le ◽  
Quoc-Hung Doan
Keyword(s):  
Blood Flow ◽  
Surgical Technique ◽  
Pulmonary Blood Flow ◽  
Thrombus Formation ◽  
Univentricular Heart ◽  
Caval Vein ◽  
Bidirectional Glenn ◽  
Cavopulmonary Anastomosis ◽  
Flow Through ◽  
New Surgical Technique

We propose a new surgical technique for superior cavopulmonary anastomosis in patients with functionally univentricular heart and bilateral superior caval veins. One of the reasons for failure of bidirectional Glenn shunts in patients with bilateral superior caval veins is the small caliber of one or both veins, with limited flow through each cavopulmonary anastomosis that can easily result in torsion, blockage, or clot formation. The conversion of two small superior caval veins into a single confluence which is large enough to connect with the pulmonary artery (PA) can resolve this problem. We present our experience with two cases in which a rolled pericardial graft was used to create a single caval vein to provide balanced pulmonary blood flow and yield growth of the central PA as well as reducing the likelihood of thrombus formation.

New approach in partial cavopulmonary connection

1998 ◽  
Vol 8 (3) ◽  
pp. 364-367 ◽  
Author(s):  
Paulo. P. Paulista ◽  
Maria Virginia. T. Santana ◽  
Antonio. T. M. Henriques Neto ◽  
Valmir F. Fontes
Keyword(s):  
Limiting Factor ◽  
Late Outcome ◽  
Caval Vein ◽  
New Approach ◽  
Inferior Caval Vein ◽  
Bidirectional Glenn Shunt ◽  
Show Evidence ◽  
The Right ◽  
Cavopulmonary Connection

AbstractThe development of pulmonary atteriovenous fistulas after bidirectional cavopuomonary operat-tions, such as the bidirectional Glenn shunt and Kawashima's procedure, has raised concern. Development of these fistulas, which are more frequent than initially thought, can represnt a limiting factor in the late outcome of these patients and may even limit the indication for these of surgery. Whether the fistulas can be reversed by transforming the surgical procedures has yet to be established. In the hope of avoiding this kind of complication, thought to be caused by the lack of passage of a hypothetical hepatic factor through the pulmonary circulation. wedevelped an inverred type of gidirectional cavopulmonary connection in which the blood coming from the liver perfuses immediately both lungs. This is made possi-ble by shuntiong via an intra-atrial tunnel the blood from the superior caval vein directly to the left atrium, and the blood from the inferior caval vein to the right branch of the pulmonary trunk (keeping its bifurcation intact). We describe findings in two patients undergoing successful surgery with this technique. Serial follow -up with cohtrast echocardiography did not show evidence of arteriovenous pulmonary fistulas.Despite our numbers being small, and the time of follow-up being limited, we believe that it is importantto document these and similar cases

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