The fenestrated Kawashima operation for single ventricle with interrupted inferior vena cava.
An 8-month-old boy with double outlet right ventricle with hypoplastic left ventricle, heterotaxy, left atrial isomerism, bilateral superior vena cavae without bridging vein, and interruption of the inferior vena cava with azygous continuation to the left superior cava underwent a bilateral bidirectional cavopulmonary anastomosis. A calibrated 3-mm connection between the right pulmonary artery and the common atrium was constructed with the proximal right superior vena cava to allow right to left shunting, analogous to a fenestration in a Fontan operation. We hypothesize that in small young patients undergoing the Kawashima operation a fenestration may improve postoperative hemodynamics.
Hannan
Robert L
RL
Division of Cardiovascular Surgery, Miami Children's Hospital, Miami, Florida 33155, USA. rhannan001@aol.com
Rossi
Anthony F
AF
Nykanen
David G
DG
Lopez
Leo
L
Alonso
Francisco
F
White
Jeffrey A
JA
Burke
Redmond P
RP
D006348:Cardiac Surgical Procedures / Q000379:methods; D004310:Double Outlet Right Ventricle / Q000601:surgery; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011651:Pulmonary Artery / Q000601:surgery; D014682:Vena Cava, Inferior / Q000002:abnormalities* / Q000601:surgery