Modified total cavopulmonary shunt as a staged Fontan operation

2017 ◽  
Vol 26 (9) ◽  
pp. 701-703
Author(s):  
Hidetsugu Asai ◽  
Tsuyoshi Tachibana ◽  
Yasushige Shingu ◽  
Hiroki Kato ◽  
Satoru Wakasa ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Right Ventricular ◽  
Superior Vena Cava ◽  
Inferior Vena ◽  
Superior Vena ◽  
Fontan Operation ◽  
Vena Cava ◽  
Left Superior Vena Cava ◽  
The Right ◽  
Cavopulmonary Shunt

The left superior vena cava became occluded in an infant with hypoplastic left heart syndrome. After a bidirectional Glenn procedure, he presented with severe oxygen desaturation and right ventricular dysfunction; the left superior vena cava drained into the inferior vena cava through collateral veins. As salvage therapy, we created a modified total cavopulmonary shunt using only autologous tissue in which the right hepatic vein and inferior vena cava drained into the pulmonary artery via a lateral tunnel in the right atrium. Immediately after surgery, his oxygen saturation increased and right ventricular function improved.

scholarly journals Vena Caval Anomalies

2013 ◽  
Vol 3 ◽  
pp. 51 ◽  
Author(s):  
Ramyah Rajakulasingam ◽  
Rohin Francis ◽  
Ramanan Rajakulasingam
Keyword(s):  
Aortic Valve ◽  
Inferior Vena Cava ◽  
Superior Vena Cava ◽  
Inferior Vena ◽  
Superior Vena ◽  
Vena Cava ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
Cardiac Procedures ◽  
The Right

Anomalous vena cavae can have significant implications for procedures on the right side of the heart. We report a rare anatomical configuration in a 44-year-old female, which to the best of our knowledge, is the first report of such an association. She had a bicuspid aortic valve in conjunction with a persistent left superior vena cava (PLSVC) draining into the coronary sinus, and a left-sided inferior vena cava (IVC) draining into a left superior vena cava via the hemiazygos vein. Comprehensive assessment of these anomalies is crucial given the widespread use of invasive cardiac procedures.

scholarly journals Right atrium and superior vena cava pressure measurements in a novel animal model to study one and a half ventricle repair as compared to Fontan type procedure

2017 ◽  
Vol 12 (4) ◽  
pp. 143-149 ◽  
Author(s):  
Anil Bhattarai ◽  
Arben Dedja ◽  
Vladimiro L. Vida ◽  
Francesco Cavallin ◽  
Massimo A. Padalino ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Inferior Vena Cava ◽  
Superior Vena Cava ◽  
Inferior Vena ◽  
Superior Vena ◽  
Stress Test ◽  
Vena Cava ◽  
Right Pulmonary Artery ◽  
The Right ◽  
Group 1

Background & Objectives: To evaluate the advantages of the one and a half ventricle repair on maintaining a low pressure in the inferior vena cava district. Also evaluate the competition of flows at the superior vena cava – right pulmonary artery anastomosis site, in order to understand the hemodynamic interaction of a pulsatile flow in combination to a laminar one. Materials & Methods: Adult rabbits (n=30) in terminal anaesthesia with a follow up of 8 h were used, randomly distributed in three experimental groups: Group 1: animals with an anastomosis between superior vena cava and right pulmonary artery, as a model of one and one half ventricle repair; Group 2: animals with the cavopulmonary anastomosis followed by clamping of the right pulmonary artery proximal to the anastomosis; and Group 3: sham animals. Pressures of superior vena cava and pulmonary arteries were afterwards measured, in a resting condition as well as after induced pharmacological stress test.Results: In Group 1, superior vena cava pressure was significantly higher, while venous pressure in the inferior vena cava – right atrium district was constant or lower in comparison with the other groups. After stress test, the pressure in the superior vena cava and the heart rate both increased further, but the right ventricular, right atrial and pulmonary artery pressures remained similar to the values in a resting condition. This proved that the inferior vena cava return was well-preserved, and no venous hypertension was present in the inferior vena cava district even after stress test (good exercise tolerance).Conclusion: One and one half ventricle repair can be considered a good surgical strategy for maintaining a low pressure in the inferior vena cava district with potential for right ventricle growth, restoring the more physiological circulation in borderline or failing right ventricle conditions. The experiment presented a positive finding in favour of one and one half ventricle repair, as compared to Fontan type procedure.

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