title: Major intrahepatic venovenous fistulas after a modified Fontan operation.
abstract: After the Fontan operation, systemic venous hypertension drives transpulmonary blood flow. Owing to this physiology, there is a significant incidence of effusions, splanchnic congestion, and generalized edema. To attentuate the effusive problems, partial exclusion of the hepatic veins has been recently practiced by Jacobs and Norwood. This report concerns a patient we recently treated for profound progressive cyanosis due to an acquired intrahepatic venovenous shunt after a Fontan operation with partial hepatic vein exclusion.
authors.affiliation: Division of Thoracic Surgery, Children's Medical Center of Dallas, TX 75235, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Reed
authors.forename: S R
authors.initials: SR
authors.lastname: Leonard
authors.forename: T M
authors.initials: TM
authors.lastname: Zellers
authors.forename: H
authors.initials: H
authors.lastname: Nikaidoh
mesh_terms: D002675:Child, Preschool; D003490:Cyanosis / Q000209:etiology; D005402:Fistula / Q000209:etiology*; D018729:Fontan Procedure / Q000009:adverse effects*; D006330:Heart Defects, Congenital / Q000601:surgery; D006503:Hepatic Veins; D006801:Humans; D008297:Male; D012086:Reoperation; D014652:Vascular Diseases / Q000209:etiology