title: A rare cause of profound cyanosis after Kawashima modification of bidirectional cavopulmonary anastomosis.
abstract: The expected level of systemic arterial saturation may not be present after bidirectional superior cavopulmonary anastomosis in children with complex congenital cardiac anomalies. We present a case of persistent severe cyanosis in a patient with azygos continuation of the inferior vena cava after bidirectional superior cavopulmonary anastomosis (Kawashima procedure) due to an intrahepatic venovenous malformation. Subsequent transcatheter deployment of two Rashkind double umbrella devices into the malformation reduced the shunt and markedly improved systemic arterial saturation.
authors.affiliation: Wessex Cardiothoracic Centre, Southampton General Hospital, United Kingdom.
authors.forename: Z
authors.initials: Z
authors.lastname: Slavik
authors.forename: R K
authors.initials: RK
authors.lastname: Lamb
authors.forename: S A
authors.initials: SA
authors.lastname: Webber
authors.forename: D J
authors.initials: DJ
authors.lastname: Delaney
authors.forename: A P
authors.initials: AP
authors.lastname: Salmon
mesh_terms: D001165:Arteriovenous Malformations / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D001166:Arteriovenous Shunt, Surgical; D002404:Catheterization; D003490:Cyanosis / Q000209:etiology*; D006330:Heart Defects, Congenital / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006503:Hepatic Veins / Q000002:abnormalities*; D006801:Humans; D007231:Infant, Newborn; D008102:Liver Circulation; D008297:Male; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000601:surgery; D014682:Vena Cava, Inferior / Q000002:abnormalities* / Q000601:surgery