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

Published online by Cambridge University Press:  28 October 2016

Jannika Dodge-Khatami ,
Avichal Aggarwal ,
Mary B. Taylor ,
Douglas Maposa ,
Jorge D. Salazar  and
Ali Dodge-Khatami
Jannika Dodge-Khatami
Affiliation:
Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
Avichal Aggarwal
Affiliation:
Division of Pediatric Cardiology, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
Mary B. Taylor
Affiliation:
Division of Pediatric Cardiology, University of Mississippi Medical Center, Jackson, Mississippi, United States of America Division of Pediatric Critical Care, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
Douglas Maposa
Affiliation:
Department of Anesthesia, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
Jorge D. Salazar
Affiliation:
Children’s Heart Center, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
Ali Dodge-Khatami*
Affiliation:
Children’s Heart Center, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
*
Correspondence to: A. Dodge-Khatami, MD, PhD, Chief, Pediatric and Congenital Heart Surgery, Children’s Heart Center, University of Mississippi Medical Center, 2500 North State Street, Room S345, Jackson, MS 39216, United States of America. Tel: +1 601 984 4693; Fax: +1 601 984 5872; E-mail: adodgekhatami@umc.edu
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Abstract

The 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.

Keywords

CHDFontanGlenn
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 5 , July 2017 , pp. 925 - 928
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Copyright
© Cambridge University Press 2016 

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References

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