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Off-pump direct hepatic veins-to-hemiazygos vein anastomosis after primary Kawashima operation: long-term result

Part of: Functionally Univentricular Heart Surgery

Published online by Cambridge University Press:  08 March 2021

Renate Kaulitz Open the ORCID record for Renate Kaulitz [Opens in a new window] ,
Gerhard Ziemer  and
Michael Hofbeck Open the ORCID record for Michael Hofbeck [Opens in a new window]
Renate Kaulitz*
Affiliation:
Department of Pediatric Cardiology and Pediatric Intensive Care Medicine, Tuebingen University Children’s Hospital, Tuebingen, Germany
Gerhard Ziemer
Affiliation:
Pediatric Cardiac Surgery, Adult Congenital Heart Surgery, Geisinger Medical Center Heart Institute, Danville, PA, USA
Michael Hofbeck
Affiliation:
Department of Pediatric Cardiology and Pediatric Intensive Care Medicine, Tuebingen University Children’s Hospital, Tuebingen, Germany
*
Author for correspondence: Renate Kaulitz, MD, Department of Pediatric Cardiology and Pediatric Intensive Care Medicine, Tuebingen University Children’s Hospital, Hoppe-Seyler Str. 1 D-72076Tuebingen, Germany. Tel: +49 7071 2984711; Fax: +49 7071 295693. E-mail: [email protected]
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Abstract

Direct hepatic veins-to-hemiazygos connection offers the balanced distribution of hepatic venous blood to both lungs, not requiring anticoagulation. We report a 13-year follow-up after this type of off-pump Fontan completion. Patient’s hepatic veins-to-hemiazygos confluence increased with growth to allow for unobstructed flow. This unique technique can be recommended in heterotaxy patients, if atrial hepatic venous drainage and hemiazygos vein are in close proximity.

Keywords

Kawashima operationheterotaxyleft isomerism
Type
Brief Report
Information
Cardiology in the Young , Volume 31 , Issue 8 , August 2021 , pp. 1340 - 1342
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Montesa, C, Karamlou, T, Ratnayaka, K, Pophal, S, Ryan, J, Nigro, J. Hepatic vein incorporation into the azygos system in heterotaxy and interrupted inferior vena cava. World J Pediatr Congenit Heart Surg 2019; 10: 330–337.CrossRefGoogle ScholarPubMed
Burstein, DS, Mavroudis, C, Puchalski, MD, Stewart, RD, Blanco, CJ, Jacobs, ML. Pulmonary arteriovenous malformations in heterotaxy syndrome: the case for early, direct hepatic vein-to-azygos vein connection. World J Pediatr Congenit Heart Surg 2011; 2: 119–128.CrossRefGoogle ScholarPubMed
Amodeo, A, Di Carlo, D, Grigioni, M, De Santis, M, Di Donato, RM. Early primary Kawashima operation combined with direct hepatic vein-to-azygos vein connection: a new logical approach. J Thorac Cardiovasc Surg 2005; 129: 949–950.CrossRefGoogle ScholarPubMed
Baskett, RJ, Ross, DB, Warren, AE, Sharratt, GP, Murphy, DA. Hepatic vein to the azygos vein anastomosis for pulmonary arteriovenous fistulae. Ann Thorac Surg 1999; 68: 232–234.CrossRefGoogle Scholar
Lopez, FE, van den Heuvel, F, Pieper, PG, Waterbolk, TW, Ebels, T. Off-pump connection of the hepatic to the azygos vein through a lateral thoracotomy for relief of arterio-venous fistulas after a Kawashima procedure. Cardiolog Young 2008; 18: 311–315.CrossRefGoogle Scholar
Kim, SJ, Bae, EJ, Lee, JY, Lim, HG, Lee, C, Lee, CH. Inclusion of the hepatic venous drainage in patients with pulmonary arteriovenous fistulas. Ann Thorac Surg 2009; 87: 548–553.CrossRefGoogle ScholarPubMed
McElhinney, DB, Marx, G, Marshall, A, Mayer, JE, del Nido, PJ. Cavopulmonary pathway modification in patients with heterotaxy and newly diagnosed or persistent pulmonary arteriovenous malformations after a modified Fontan operation. J Thorac Cardiovasc Surgery 2011; 141: 1362–1370.CrossRefGoogle ScholarPubMed
Gordon-Walker, TT, Bove, K, Veldtman, G. Fontan-associated liver disease: A review. J Cardiol 2019; 74: 223–232.CrossRefGoogle ScholarPubMed