Pediatric Cardiology

, Volume 27, Issue 3, pp 381–384 | Cite as

Enlarged Left Vitelline Vein Remnant as a Cause of Cyanosis after the Fontan Procedure: Resolution with an Amplatzer Vascular Plug

Article

Abstract

A 6-year-old girl with heterotaxy and a functional single ventricle had persistent cyanosis 4 years after a fenestrated Fontan procedure. Cardiac catheterization revealed a large venous fistula from a left-sided hepatic vein to the coronary sinus, resulting in desaturation. The anomalous vein was occluded with an Amplatzer vascular plug.

Keywords

Cyanosis Fontan Venous collateral 

References

  1. 1.
    Erickson LC, Lopez A, Vlahakes GJ, et al. (1996) Massive intrahepatic shunting seen as severe cyanosis after the Fontan procedure in heterotaxy syndrome. Am Heart J 131:608–611PubMedCrossRefGoogle Scholar
  2. 2.
    Fernandez-Martorell P, Sklansky MS, Lucas VW, et al. (1996) Accessory hepatic vein to pulmonary venous atrium as a cause of cyanosis after the Fontan operation. Am J Cardiol 77:l386–l387CrossRefGoogle Scholar
  3. 3.
    Giamberti A, Anderson RH, de Leval MR (2002) Intrahepatic right-to-left shunting after the Fontan operation. Cardiol Young 12:308–310PubMedGoogle Scholar
  4. 4.
    Guérin P, Losay J, Baron O (2005) Transcatheter occlusion of an intrahepatic venovenous fistula after modified Fontan circulation by implantation of an Amplatzer atrial septal occluder. Cathet Cardiovasc Interv 64:117–120CrossRefGoogle Scholar
  5. 5.
    Hishitani T, Ogawa K, Hoshino K, Nakamura Y (1999) Surgical ligation of anomalous hepatic vein in a case of heterotaxy syndrome with massive intrahepatic shunting after modified Fontan operation. Pediatr Cardiol 20:428–430PubMedCrossRefGoogle Scholar
  6. 6.
    Jacobs M, Norwood WJ (1994) Fontan operation: influence of modifications on morbidity and mortality. Ann Thorac Surg 58:945–952PubMedCrossRefGoogle Scholar
  7. 7.
    Kawashima Y, Kitamura S, Matsuda H, et al. (1984) Total cavopulmonary shunt operation in complex cardiac anomalies. J Thorac Cardiovasc Surg 87:74–81PubMedGoogle Scholar
  8. 8.
    Magee AG, McCrindle BW, Mawson J, et al. (1998) Systemic venous collateral development after the bidirectional cavopulmonary anastomosis. Prevalence and predictors. J Am Coll Cardiol 32:502–508PubMedCrossRefGoogle Scholar
  9. 9.
    McElhinney DB, Reddy VM, Hanley FL, Moore P (1997) Systemic venous collateral channels causing desaturation after bidirectional cavopulmonary anastomosis: evaluation and management. J Am Coll Cardiol 30:817–824PubMedCrossRefGoogle Scholar
  10. 10.
    Moore JW, Murdison KA, Baffa GM, Kashow K, Murphy JD (2000) Transcatheter closure of fenestrations and excluded hepatic veins after Fontan: versatility of the Amplatzer device. Am Heart J 140:534–540PubMedCrossRefGoogle Scholar
  11. 11.
    Rao IM, Swanson JS, Hovaguimian H, et al. (1995) Intrahepatic steal after Fontan operation with partial hepatic exclusion. J Thorac Cardiovasc Surg 109:180–181PubMedCrossRefGoogle Scholar
  12. 12.
    Reed MK, Leonard SR, Zellers TM, Nikaidoh H (1996) Major intrahepatic venovenous fistulas after a modified Fontan operation. Ann Thorac Surg 61:713–715PubMedCrossRefGoogle Scholar
  13. 13.
    Ro PS, Weinberg PM, Delrosario J, Rome JJ (2001) Predicting the identity of decompressing veins after cavopulmonary anastomoses. Am J Cardiol 88:1317–1320PubMedCrossRefGoogle Scholar
  14. 14.
    Saliba Z, Boudjemline Y, Acar P, et al. (2002) Transhepatic closure of a post-Fontan hepatic veins to left atrium fenestration in visceral heterotaxia and dextrocardia. J Interv Cardiol 15:215–217PubMedGoogle Scholar
  15. 15.
    Schneider DJ, Banerjee A, Mendelsohn AM, Norwood WI (1997) Hepatic venous malformation after modified Fontan procedure with partial hepatic vein exclusion. Ann Thorac Surg 63:1177–1179PubMedCrossRefGoogle Scholar
  16. 16.
    Srivastava D, Preminger T, Lock JE, et al. (1995) Hepatic venous blood and the development of pulmonary arteriovenous malformations in congenital heart disease. Circulation 22:1217–1222Google Scholar
  17. 17.
    Szkutnik M, Bialkowski J, Knapik P (2001) Major intrahepatic venovenous fistula after modified Fontan operation treated by transcatheter implantation of Amplatzer septal occluder. Cardiol Young 11:357–360PubMedGoogle Scholar
  18. 18.
    Tofeig M, Walsh KP, Arnold R (1998) Transcatheter occlusion of a post-Fontan residual hepatic vein to pulmonary venous atrium communication using the Amplatzer septal occluder. Heart 79:624–626PubMedGoogle Scholar
  19. 19.
    Yoshimura N, Yamaguchi M, Oshima Y, Tei T, Ogawa K (1999) Intrahepatic venovenous shunting to an accessory hepatic vein after Fontan type operation. Ann Thorac Surg 67:1494–1496PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • A. Rothman
    • 1
  • R.J. Acherman
    • 1
  • C.F. Luna
    • 1
  • H. Restrepo
    • 1
  1. 1.Children’s Heart Center and the Department of PediatricsUniversity of Nevada School of MedicineLas VegasUSA

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