Intrahepatic right-to-left shunting after the Fontan operation.
We describe two patients with right isomerism, corrected with a fenestrated Fontan operation, who suffered severe progressive cyanosis. Cardiac catheterisation in both revealed a massive right-to-left shunt from the inferior caval vein, through the liver, to a hepatic vein draining directly to the left side of the intra-atrial baffle. The anomalous vein was successfully ligated in both patients.
D002648:Child; D002675:Child, Preschool; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D003490:Cyanosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D018729:Fontan Procedure / Q000009:adverse effects*; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011859:Radiography; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000601:surgery*