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Intracardiac or extracardiac conduit modification of the Fontan procedure in hearts with univentricular atrioventricular connection and left superior caval vein draining to coronary sinus

Published online by Cambridge University Press:  19 August 2008

Jacques A.M. van Son ,
Volkmar Falk  and
Friedrich W. Mohr
Jacques A.M. van Son*
Affiliation:
Herzzentrum, University of Leipzig, Leipzig, Germany
Volkmar Falk
Affiliation:
Herzzentrum, University of Leipzig, Leipzig, Germany
Friedrich W. Mohr
Affiliation:
Herzzentrum, University of Leipzig, Leipzig, Germany
*
Dr. Jacques A.M. van Son, Herzzentrum, University of Leipzig, Russenstrasse 19, D-04289, Leipzig, Germany. Tel: 49-341-865 1445; Fax: 49-341-865 1452
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Abstract

In 3 patients with isomeric morphologically left atrial appendages, univentricular atrioventricular connection, concordant ventriculoarterial connections, bilateral superior caval veins, with the left one draining via the coronary sinus, together with absence of any communicating vein, interruption of inferior caval vein with drainage via a right-sided (n=2) or left-sided (n=l) azygos vein, the hepatic venous blood was rerouted via the large coronary sinus into the pulmonary arterial circulation. In a fourth patient with similar pathology, having interruption of the left-sided inferior caval vein with drainage to the left-sided superior caval vein via a left-sided azygos vein and a large communicating vein, the pathway from the left superior caval vein to the coronary sinus was correspondingly small. An extracardiac conduit was therefore constructed between the hepatic veins and the left pulmonary artery so as to reroute the hepatic venous blood into the pulmonary arterial circulation. At a mean follow-up of 8.5 months, all patients are clinically well and none of them have developed pulmonary arteriovenous malformations. To avoid the latter complication in Fontan physiology, especially in the setting of an interrupted inferior caval vein with drainage via the azygos vein, we believe that it is preferable to reroute the hepatic venous blood into the pulmonary circulation.

Keywords

Visceral heterotaxyleft superior caval veinFontan operation
Type
Original Articles
Information
Cardiology in the Young , Volume 7 , Issue 2 , April 1997 , pp. 215 - 219
Copyright
Copyright © Cambridge University Press 1997

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