A pitfall in ligation of intrahepatic shunting after Fontan type operation.
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.
Ikeda
Akihiko
A
Department of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Japan.
Hiramatsu
Yuji
Y
Horigome
Hitoshi
H
Hori
Tetsuo
T
Noma
Mio
M
Sakakibara
Yuzuru
Y
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