Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-24T08:48:30.577Z Has data issue: false hasContentIssue false

‘You didn't see them, but now you do!': use of balloon occlusion angiography in the identification of systemic venous anomalies before and after cavopulmonary procedures

Published online by Cambridge University Press:  19 August 2008

Caroline Ovaert
Affiliation:
The Department of Pediatrics, Division of Cardiology, The Variety Club Catheterization Laboratories, The University of Toronto Faculty of Medicine, Toronto, Canada
Luc H. P. M Filippini
Affiliation:
The Department of Pediatrics, Division of Cardiology, The Variety Club Catheterization Laboratories, The University of Toronto Faculty of Medicine, Toronto, Canada
Lee M. Benson
Affiliation:
The Department of Pediatrics, Division of Cardiology, The Variety Club Catheterization Laboratories, The University of Toronto Faculty of Medicine, Toronto, Canada
Robert M. Freedom*
Affiliation:
The Department of Pediatrics, Division of Cardiology, The Variety Club Catheterization Laboratories, The University of Toronto Faculty of Medicine, Toronto, Canada
*
Robert M. Freedom, MD, FRCP, The Hospital for Sick Children, 555 University Avenue, Toronto, OntarioCanada, M5G 1X8. Fax: 416 813 7547; Tel: 416 813 6132; e-mail: [email protected]

Abstract

We describe the importance of angiographic identification of collateral venous channels by balloon occlusion venography after bidirectional cavopulmonary connections. Use of the balloon occlusion technique is essential for identification of these vessels, as they can easily be missed by standard venous angiography, with possible clinical consequences for postoperative management.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Magee, A.G., McCrindle, B.W, Mawson, J, Benson, L.N., Williams, W.G., Freedom, R.M. Systemic venous collaterals after the bidirectional cavopulmonary shunt: prevalence and risk factors. [Abstract] XXXI Annual Meeting of the AEPC 1996Google Scholar
2.Gatzoulis, M.A., Shinebourne, E.A., Redington, A.N., Rigby, M.L., Shore, D.F.Increasing cyanosis early after cavopulmonary connection caused by abnormal systemic venous channels. Br Heart J 1995; 73: 182186CrossRefGoogle ScholarPubMed
3.Laks, H, Mudd, G.J., Standeven, J.W., Jagan, L, Willman, VL. Longterm effect of the superior vena cava-pulmonary artery anastomosis on pulmonary blood flow. J Thorac Cardiovasc Surg 1980; 74: 253260CrossRefGoogle Scholar
4.Stumper, O, Wright, J.G.C., Sadiq, M, De Giovanni, J.V.Late systemic desaturation after total cavopulmonary shunt operations. Br Heart J 1995; 74: 282286CrossRefGoogle ScholarPubMed
5.Mazzucco, A, Bortolotti, U, Stellin, G, Gallucci, VAnomalies of the systemic venous return: a review. J Card Surg 1990; 5(2): 122133CrossRefGoogle ScholarPubMed
6.Huhta, J.C., Smallhorn, J.F., Macartney, F.J., Anderson, R.H., de Leval, M.Cross-sectional echocardiographic diagnosis of systemic venous return. Br Heart J 1982; 48: 388403CrossRefGoogle ScholarPubMed
7.Freedom, RM, Mawson, JB, Yoo, S, Benson, LN; Congenital heart Disease. Textbook of angiocardiography. Futura Publishing Company, Inc.; Armonk, NY; 1997, p. 289337Google Scholar
8.Buirski, G, Jordan, SC, Joffe, HS, Wide, E, Superior vena caval abnormalities: their occurrence rate, associated cardiac abnormalities and angiographic classification in a paediatric population with congenital heart disease. Clinical Radiology 1986; 37(2):131138CrossRefGoogle Scholar
9.Parikh, SR, Prasad, K, Iyer, RN, Desai, N, Mohankrishna, L. Prospective angiographic study of the abnormalities of systemic venous connections in congenital and acquired heart disease. Cathet Cardiovasc Diagn 1996; 38: 3793863.0.CO;2-A>CrossRefGoogle ScholarPubMed
10.de Leval, M, Ritter, DG, McGoon, DC, Danielson, GK. Anomalous systemic venous connection. Surgical considerations. Mayo Clin Proc 1975; 50: 599610Google ScholarPubMed
11.Bargeron, LM, Karp, TB, Barcia, A, Kirklin, JW, Hunt, D, Deverall, PB. Late deterioration of patients after superior venacava to right pulmonary anastomosis. Am J Cardiol 1972; 30: 211216CrossRefGoogle Scholar
12.Bridges, ND, Jonas, RA, Mayer, JE, Flanagan, MF, Keane, JF, Castaneda, AR. Bidirectionnal cavo-pulmonary anastomosis as interim palliation for high-risk Fontan candidates: early results. Circulation 1990; 82(suppl IV): 170176Google Scholar
13.Pennington, DG, Nouri, S, Ho, J, Seeker-Walker, R, Patel, B, Sivakoff, M, Willamann, BL. Glenn shunt: long-term results and current role in congenital heart operations. Ann Thorac Surg 1980; 31: 532539CrossRefGoogle Scholar
14.McElhinney, DB, Reddy, V, Hanley, FL, Moore, P.Systemic venous collateral channels causing desaturation after bidirectional cavopulmonary anastomosis. JACC 1997; 30(3): 817824CrossRefGoogle ScholarPubMed
15.Filippini, LHPM, Ovaert, C, Nykanen, DG, Freedom, RM. Re opening of a persistent left superior caval vein after bi-directional cavopulmonary connections. Heart 1998; (in press)CrossRefGoogle Scholar
16.Freed, MD, Rosenthal, A, Bernhard, WE. Balloon occlusion of a persistent left superior vena cava in the preoperative evaluation of systemic venous return. J Thorac Cardiovasc Surg 1973; 65: 835839CrossRefGoogle ScholarPubMed
17.Denham, B, Ward, OC, McCann, P, Blake, N. Aortography in infantile coarctation. A simple and effective technique. Arch Dis Child 1979; 54: 717719CrossRefGoogle ScholarPubMed
18.Fiddler, GI, Partridge, JB. Balloon occlusion angiography in critically ill neonates. Cathet Cardiovasc Diagn 1983; 9: 309312CrossRefGoogle ScholarPubMed
19.Keane, JF, McFaul, R, Fellows, K, Lock, J. Balloon occlusion angiography in infancy: methods, uses and limitations. Am J Cardiol 1985; 56: 495–497CrossRefGoogle ScholarPubMed
20.Vincent, RN, Hawkins, LE, Pelech, AN, Collins, GF. Balloon occlusion angiography. Can J Cardiol 1987; 3(2): 5259Google ScholarPubMed
21.Lo, RNS, Leung, MP, Lau, KC. Demonstration of ascending aorta in hypoplastic left heart syndrome with aortic atresia by balloon occlusion aortography. Pediatr Radiol 1987; 17: 370372CrossRefGoogle ScholarPubMed
22.Hofbeck, M, Wild, F, Singer, H. Improved visualisation of a coronary artery fistula by the “laid-back” aortogram. Br Heart J 1993; 70 272273CrossRefGoogle ScholarPubMed