Does superior caval vein pressure impact head growth in Fontan circulation?

2016 ◽  
Vol 26 (7) ◽  
pp. 1327-1332
Author(s):  
Tina Trachsel ◽  
Christian Balmer ◽  
Håkan Wåhlander ◽  
Roland Weber ◽  
Hitendu Dave ◽  
...  
Keyword(s):  
Head Circumference ◽  
Single Ventricle ◽  
Communicating Hydrocephalus ◽  
Caval Vein ◽  
Single Ventricle Physiology ◽  
Superior Caval Vein ◽  
Cavopulmonary Anastomosis ◽  
Pressure Impact ◽  
By Catch ◽  
Bidirectional Cavopulmonary Anastomosis

AbstractBackgroundPatients with bidirectional cavopulmonary anastomosis have unphysiologically high superior caval vein pressure as it equals pulmonary artery pressure. Elevated superior caval vein pressure may cause communicating hydrocephalus and macrocephaly. This study analysed whether there exists an association between head circumference and superior caval vein pressure in patients with single ventricle physiology.MethodsWe carried out a retrospective analysis of infants undergoing Fontan completion at our institution from 2007 to 2013. Superior caval vein pressures were measured during routine catheterisation before bidirectional cavopulmonary anastomosis and Fontan completion as well as head circumference, adjusted to longitudinal age-dependent percentiles.ResultsWe included 74 infants in our study. Median ages at bidirectional cavopulmonary anastomosis and Fontan were 4.8 (1.6–12) and 27.9 (7–40.6) months, respectively. Head circumference showed significant growth from bidirectional cavopulmonary anastomosis until Fontan completion (7th (0–100th) versus 20th (0–100th) percentile). There was no correlation between superior caval vein pressure and head circumference before Fontan (R2=0.001). Children with lower differences in superior caval vein pressures between pre-bidirectional cavopulmonary anastomosis and pre-Fontan catheterisations showed increased growth of head circumference (R2=0.19).ConclusionsPatients with moderately elevated superior caval vein pressure associated with single ventricle physiology did not have a tendency to develop macrocephaly. There is no correlation between superior caval vein pressure before Fontan and head circumference, but between bidirectional cavopulmonary anastomosis and Fontan head circumference increases significantly. This may be explained by catch-up growth of head circumference in patients with more favourable haemodynamics and concomitant venous pressures in the lower range. Further studies with focus on high superior caval vein pressures are needed to exclude or prove a correlation.

Fontan completion in reverse order out of necessity: secondary Glenn after primary extracardiac inferior cavopulmonary artery connection

2016 ◽  
Vol 27 (5) ◽  
pp. 925-928 ◽  
Author(s):  
Jannika Dodge-Khatami ◽  
Avichal Aggarwal ◽  
Mary B. Taylor ◽  
Douglas Maposa ◽  
Jorge D. Salazar ◽  
...  
Keyword(s):  
Single Ventricle ◽  
Upper Body ◽  
Reverse Order ◽  
Venous Anatomy ◽  
Caval Vein ◽  
Single Ventricle Physiology ◽  
Superior Caval Vein ◽  
Good Outcome ◽  
Cavopulmonary Connection

AbstractThe primary extracardiac inferior cavopulmonary connection is an unusual novel palliation for single-ventricle physiology, which we first performed in the setting of unfavourable upper-body systemic venous anatomy for a standard bi-directional Glenn, and in lieu of leaving our patient with shunt-dependent physiology. After an initial 16-month satisfactory follow-up, increasing cyanosis led to the discovery of a veno-venous collateral that was coiled, but, more importantly, to impressive growth of a previously diminutive superior caval vein, which allowed us to perform completion Fontan with a good outcome. Performing the single-ventricle staging in a reverse manner, first from below with a primary inferior cavopulmonary connection, followed by Fontan completion from above with a standard superior caval vein bi-directional Glenn, is also possible when deemed necessary.

An unexpected case of post-operative superior caval vein syndrome

2018 ◽  
Vol 28 (6) ◽  
pp. 879-881 ◽  
Author(s):  
Lynn Peng ◽  
Lisa Wise-Faberowski
Keyword(s):  
Unusual Case ◽  
Heart Surgery ◽  
Single Ventricle ◽  
Congenital Heart Surgery ◽  
Caval Vein ◽  
External Compression ◽  
Superior Caval Vein ◽  
Single Ventricle Palliation ◽  
Catheterisation Laboratory ◽  
Tetralogy Of Fallot Repair

AbstractSuperior caval vein obstruction in children after congenital heart surgery has been more associated with thrombosis formation as result of single-ventricle palliation, infection, indwelling devices/catheters, or external compression. Many of these patients will present to the cardiac catheterisation laboratory for evaluation and possible intervention. We present an unusual case of superior caval vein obstruction in a patient after Tetralogy of Fallot repair.

scholarly journals Risk factors associated with post-transplant superior caval vein stenosis in paediatric heart transplantation

2021 ◽  
pp. 1-6
Author(s):  
Hanna J. Tadros ◽  
Joseph T. Whelihan ◽  
Dalia Lopez-Colon ◽  
James C. Fudge ◽  
Himesh V. Vyas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Transplantation ◽  
Retrospective Review ◽  
Catheter Intervention ◽  
Single Centre ◽  
Caval Vein ◽  
Factors Associated ◽  
Superior Caval Vein ◽  
Cavopulmonary Anastomosis ◽  
Vein Stenosis

Abstract Superior caval vein stenosis is a known complication following paediatric heart transplantation. Herein, we sought to assess the incidence of superior caval vein stenosis and need for intervention in a single centre paediatric heart transplantation programme. A retrospective review was performed to identify variables associated with superior caval vein stenosis and need for intervention. Patients were identified based on angiographic and echocardiographic signs of superior caval vein stenosis. Of 204 paediatric heart transplantation recipients, 49 (24.0%) had evidence of superior caval vein stenosis with no need for catheter intervention and 12 (5.9%) had superior caval vein stenosis requiring catheter intervention. Overall, patients with superior caval vein stenosis with and without intervention had more cavopulmonary anastomosis (41.7%; 20.4%), pre-transplant superior caval vein procedures (41.7%; 28.6%), and bicaval approach (100.0%; 98.0%), compared to the group with no stenosis (11.9% and p = 0.015, 12.6% and p = 0.004, 73.4% and p < 0.001, respectively). Smaller recipients and donors were more likely to need intervention. Intervention was also seen more frequently in recipients who were younger at diagnosis (4.7 years) compared to non-intervention (13.3 years; p = 0.040). Re-intervention was required in 16.7% patients (n = 2) and was not associated with any complications.

Cavopulmonary anastomosis without concomitant valvoplasty in patients with single ventricle physiology

2014 ◽  
Vol 30 (1) ◽  
pp. 6-10
Author(s):  
Sivakumar Sivalingam ◽  
Sivakumar Krishnasamy ◽  
Tan Yau Hong ◽  
Pau Kew Kong ◽  
Mazeni Alwi ◽  
...  
Keyword(s):  
Single Ventricle ◽  
Single Ventricle Physiology ◽  
Cavopulmonary Anastomosis

scholarly journals Contralateral Unidirectional Cavopulmonary Shunt for Single Ventricle Palliation

2021 ◽  
Author(s):  
Anisha Agrawal ◽  
Jeevanandam N ◽  
Shekhar Saxena ◽  
Roy Varghese
Keyword(s):  
Pulmonary Artery ◽  
Single Ventricle ◽  
Left Pulmonary Artery ◽  
Contralateral Side ◽  
Caval Vein ◽  
Superior Caval Vein ◽  
Pulmonary Arterial ◽  
The Right ◽  
Cavopulmonary Shunt ◽  
Single Ventricle Palliation

Unidirectional cavo pulmonary shunt supplemented with systemic to pulmonary arterial shunt is often necessary for palliation of single ventricle with unilateral hypoplasia of a pulmonary artery. In rare instances, the adequately sized pulmonary artery is on the contralateral side as the superior caval vein making this anastomosis challenging. This report describes the operative technique involved in construction of the right superior caval vein to left pulmonary artery anastomosis.

Unilateral unidirectional superior cavopulmonary anastomosis in a patient with bilateral superior caval veins and atretic left pulmonary artery

2018 ◽  
Vol 29 (3) ◽  
pp. 416-418
Author(s):  
Sachin Talwar ◽  
Mayank Yadav ◽  
Shiv Kumar Choudhary
Keyword(s):  
Pulmonary Artery ◽  
Left Pulmonary Artery ◽  
Prosthetic Material ◽  
Univentricular Heart ◽  
Caval Vein ◽  
Superior Caval Vein ◽  
Cavopulmonary Anastomosis ◽  
Right Pulmonary Artery ◽  
The Right ◽  
Patent Arterial Duct

AbstractA unidirectional superior cavopulmonary anastomosis was performed on the right side in a patient with a functionally univentricular heart, atresia of main and left pulmonary artery, bilateral superior caval veins, and a patent arterial duct in the right pulmonary artery. Anastomosis of the left superior caval vein to the right superior caval vein created a neo-innominate vein without using prosthetic material.

Extracorporeal membrane oxygenation for pneumonitis after a Glenn palliation

Perfusion ◽  
2002 ◽  
Vol 17 (6) ◽  
pp. 457-458 ◽  
Author(s):  
James C Nielsen ◽  
Howard S Seiden ◽  
Khanh Nguyen ◽  
Susan A Vlahakis ◽  
Chitra Ravishankar
Keyword(s):  
Respiratory Syncytial Virus ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Insufficiency ◽  
Single Ventricle ◽  
Extra Corporeal Membrane Oxygenation ◽  
Membrane Oxygenation ◽  
Cavopulmonary Anastomosis ◽  
Syncytial Virus ◽  
Bidirectional Cavopulmonary Anastomosis ◽  
Ecmo Therapy

A five-month old male with a single ventricle palliated with a bidirectional cavopulmonary anastomosis developed severe respiratory insufficiency from respiratory syncytial virus (RSV) pneumonitis. He was successfully rescued with extra-corporeal membrane oxygenation (ECMO) therapy and recovered with minimal morbidity.

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