Usefulness of intraoperative color doppler ultrasonography in decision making regarding conversion of an accessory hepatic vein after a Fontan-type operation.
An accessory hepatic vein (AHV) after a Fontan-type operation will result in progressive desaturation if left intact. We report a case in which intraoperative color Doppler ultrasonography revealed the absence of AHV flow and reversed portal vein flow when the AHV was clamped, suggesting that simple ligation of the AHV would lead to liver dysfunction in the area affected. Based on the results of the ultrasonography evaluations, diversion of the AHV into the pulmonary circulation was performed without cardiopulmonary bypass, and the clinical outcome has been favorable.
Maeda
K
K
Department of Cardiothoracic Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. maedak-tky@umin.ac.jp
Murakami
A
A
Takaoka
T
T
Takamoto
S
S
Sano
K
K
Makuuchi
M
M
D000293:Adolescent; D005260:Female; D018729:Fontan Procedure; D006503:Hepatic Veins / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D007430:Intraoperative Care; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D008102:Liver Circulation / Q000502:physiology; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000601:surgery; D011652:Pulmonary Circulation / Q000502:physiology; D018615:Ultrasonography, Doppler, Color