title: A pitfall in ligation of intrahepatic shunting after Fontan type operation.
abstract: An 8-year-old boy experienced progressive cyanosis after a Fontan type operation. Under the guidance of intraoperative color Doppler we performed a transabdominal ligation of the accessory hepatic veins which drained into a common atrium. Reoperation was needed through a median sternotomy to eliminate residual shunting. Although intraoperative Doppler is useful to aid in the ligation of accessory veins while portal hypertension is monitored, intraoperative angiogram serves better to ensure the elimination of intrahepatic shunting in a transabdominal approach.
authors.affiliation: Department of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Ikeda
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hiramatsu
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Horigome
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Hori
authors.forename: Mio
authors.initials: M
authors.lastname: Noma
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Sakakibara
mesh_terms: D000792:Angiography; D002648:Child; D003490:Cyanosis / Q000209:etiology*; D018729:Fontan Procedure / Q000009:adverse effects* / Q000379:methods; D006503:Hepatic Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008026:Ligation / Q000009:adverse effects; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D018615:Ultrasonography, Doppler, Color