New approach to the surgical management of pulmonary arteriovenous malformations after cavopulmonary anastomosis.
The development of pulmonary arteriovenous malformations after cavopulmonary bypass in patients with congenital heart disease is well documented. We report successful management of pulmonary arteriovenous malformations after cavopulmonary bypass in a patient with an interrupted inferior vena cava (IVC) and multiple hepatic veins utilizing an extracardiac conduit from the hepatic veins to the hemiazygous continuation of the interrupted IVC. This technique, performed without circulatory arrest or an atriotomy, may limit morbidity associated with intracardiac procedures in patients with single ventricle morphology. Furthermore, this case suggests an alternative technique for completion Fontan in patients with an interrupted IVC and multiple hepatic venous drainage.
Department of Cardiovascular Surgery, SUNY Upstate Medical University, Syracuse, New York 13210, USA. steinbja@upstate.edu
Jay
J
Steinberg
George M
GM
Alfieris
Berkeley
B
Brandt
Frank
F
Smith
Craig J
CJ
Byrum
Gregory W
GW
Fink
Jeffrey
J
Halter
D000293:Adolescent; D000714:Anastomosis, Surgical; D001164:Arteriovenous Fistula / Q000209:etiology / Q000601:surgery*; D001401:Azygos Vein / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D018610:Heart Bypass, Right / Q000009:adverse effects*; D006503:Hepatic Veins / Q000002:abnormalities / Q000601:surgery; D006801:Humans; D008297:Male; D011652:Pulmonary Circulation; D014682:Vena Cava, Inferior / Q000002:abnormalities / Q000601:surgery