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Off-pump connection of the hepatic to the azygos vein through a lateral thoracotomy for relief of arterio-venous fistulas after a Kawashima procedure

Published online by Cambridge University Press:  01 June 2008

Fatima E.F.G. Lopez ,
Freek van den Heuvel ,
Petronella G. Pieper ,
Tjalling W. Waterbolk  and
Tjark Ebels
Fatima E.F.G. Lopez
Affiliation:
Division of Cardiothoracic Surgery, University Medical Centre Groningen, Groningen, The Netherlands
Freek van den Heuvel
Affiliation:
Division of Cardiothoracic Surgery, University Medical Centre Groningen, Groningen, The Netherlands
Petronella G. Pieper
Affiliation:
Division of Cardiothoracic Surgery, University Medical Centre Groningen, Groningen, The Netherlands
Tjalling W. Waterbolk
Affiliation:
Division of Cardiothoracic Surgery, University Medical Centre Groningen, Groningen, The Netherlands
Tjark Ebels*
Affiliation:
Division of Cardiothoracic Surgery, University Medical Centre Groningen, Groningen, The Netherlands
*
Correspondence to: T. Ebels MD, Ph, Department Cardiothoracic Surgery, University Medical Centre Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands. Tel: +31-503613238; Fax: +31-503611347; E-mail: T.Ebels@thorax.umcg.nl
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Abstract

Objective

To connect the hepatic veins to the azygos venous system through a lateral thoracotomy, and without the use of extracorporeal circulation, so as to relieve arteriovenous fistulas after a previous Kawashima operation.

Methods

Description of the operative technique by which the hepatic veins are anastomosed to the hepatic venous system.

Results

The surgical approach was successfully applied in 3 patients, all of whom showed an excellent rise of saturations of oxygen after redirection of the hepatic venous blood.

Conclusion

The operative method presented is an elegant means of redirecting the hepatic venous blood to the pulmonary circulation without the disadvantages of extracorporeal circulation and resternotomy.

Keywords

Extracorporeal cardiopulmonary bypasssurgical approachleft isomerismrelapsing cyanosis
Type
Original Article
Information
Cardiology in the Young , Volume 18 , Issue 3 , June 2008 , pp. 311 - 315
Copyright
Copyright © Cambridge University Press 2008

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References

1.Baskett, RJ, Ross, DB, Warren, AE, Sharratt, GP, Murphy, DA. Hepatic vein to the azygous vein anastomosis for pulmonary arteriovenous fistulae. Ann Thor Surg 1999; 68: 232–233.CrossRefGoogle Scholar
2.Kaneko, Y, Murakami, A, Miyamoto, T, Takamoto, S. Hepatic vein-to-azygos vein connection in a patient with interrupted inferior vena cava. Eur J Cardiothorac Surg 2002; 21: 582–584.CrossRefGoogle Scholar
3.Uemura, H, Yagihara, T, Hattori, R, Kawahira, Y, Tsukano, S, Watanabe, K. Redirection of hepatic venous drainage after total cavopulmonary shunt in left isomerism. Ann Thorac Surg 1999; 68: 1731–1735.CrossRefGoogle ScholarPubMed
4.Kawashima, Y, Kitamura, S, Matsuda, H, Shimazaki, Y, Nakano, S, Hirose, H. Total cavopulmonary shunt operation in complex cardiac anomalies. A new operation. J Thorac Cardiovasc Surg 1984; 87: 74–81.CrossRefGoogle ScholarPubMed
5.Srivastava, D, Preminger, T, Lock, JE, et al. Hepatic venous blood and the development of pulmonary arteriovenous malformations in congenital heart disease. Circulation 1995; 92: 1217–1222.CrossRefGoogle ScholarPubMed
6.Duncan, BW, Desai, S. Pulmonary arteriovenous malformations after cavopulmonary anastomosis. Ann Thorac Surg 2003; 76: 1759–1766.CrossRefGoogle ScholarPubMed
7.Shah, MJ, Rychik, J, Fogel, MA, Murphy, JD, Jacobs, ML. Pulmonary AV malformations after superior cavopulmonary connection: resolution after inclusion of hepatic veins in the pulmonary circulation. Ann Thorac Surg 1997; 63: 960–963.CrossRefGoogle ScholarPubMed
8.Konstantinov, IE, Puga, FJ, Alexi-Meskishvili, VV. Thrombosis of intracardiac or extracardiac conduits after modified Fontan operation in patients with azygous continuation of the inferior vena cava. Ann Thorac Surg 2001; 72: 1641–1644.CrossRefGoogle ScholarPubMed
9.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
10.Steinberg, J, Alfieris, GM, Brandt, B, et al. New approach to surgical management of pulmonary arteriovenous malformations after cavopulmonary anastomosis. Ann Thor Surg 2003; 75: 1640–1642.CrossRefGoogle ScholarPubMed
11.Uemura, H, Ho, SY, Devine, WA, Kilpatrick, LL, Anderson, RH. Atrial appendages and venoatrial connections in hearts from patients with visceral heterotaxy. Ann Thor Surg 1995; 60: 561–569.CrossRefGoogle ScholarPubMed