Regression of severe pulmonary arteriovenous malformations after Fontan revision and "hepatic factor" rerouting.
Although previously described in patients undergoing staged palliation for univentricular heart disease, the mechanism by which hepatic venous flow prevents development of pulmonary arteriovenous malformations is still not completely understood. We present a case in which successful H-type Fontan revision with rerouting of hepatic venous flow through a hemiazygous vein successfully reversed the progression of severe left pulmonary arteriovenous malformations.
Division of Cardiothoracic Surgery, David Geffen School of Medicine at University of California-Los Angeles, UCLA Box 951741, Los Angeles, CA 90095-1741, USA. npike@mednet.ucla.edu
Nancy A
NA
Pike
Luca A
LA
Vricella
Jeffrey A
JA
Feinstein
Michael D
MD
Black
Bruce A
BA
Reitz
D000015:Abnormalities, Multiple / Q000601:surgery*; D001164:Arteriovenous Fistula / Q000209:etiology / Q000601:surgery*; D001166:Arteriovenous Shunt, Surgical; D002648:Child; D003490:Cyanosis; D005260:Female; D018729:Fontan Procedure; D006330:Heart Defects, Congenital / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities*; D018056:Hemorheology; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D010166:Palliative Care; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D019736:Prostheses and Implants; D011651:Pulmonary Artery / Q000601:surgery*; D011664:Pulmonary Valve / Q000601:surgery; D012857:Situs Inversus; D014684:Venae Cavae / Q000002:abnormalities