Off-pump connection of the hepatic to the azygos vein through a lateral thoracotomy for relief of arterio-venous fistulas after a Kawashima procedure.
OBJECTIVE
To connect the hepatic veins to the azygos venous system through a lateral thoracotomy, and without the use of extracorporeal circulation, so as to relieve arteriovenous fistulas after a previous Kawashima operation.


METHODS
Description of the operative technique by which the hepatic veins are anastomosed to the hepatic venous system.


RESULTS
The surgical approach was successfully applied in 3 patients, all of whom showed an excellent rise of saturations of oxygen after redirection of the hepatic venous blood.


CONCLUSIONS
The operative method presented is an elegant means of redirecting the hepatic venous blood to the pulmonary circulation without the disadvantages of extracorporeal circulation and resternotomy.
Lopez
Fatima E F G
FE
Division of Cardiothoracic Surgery, University Medical Centre Groningen, Groningen, The Netherlands.
van den Heuvel
Freek
F
Pieper
Petronella G
PG
Waterbolk
Tjalling W
TW
Ebels
Tjark
T
D000328:Adult; D001164:Arteriovenous Fistula / Q000209:etiology / Q000601:surgery*; D020517:Atrial Appendage / Q000002:abnormalities*; D001401:Azygos Vein / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002648:Child; D005260:Female; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D013908:Thoracotomy