title: Fontan completion in reverse order out of necessity: secondary Glenn after primary extracardiac inferior cavopulmonary artery connection.
abstract: The primary extracardiac inferior cavopulmonary connection is an unusual novel palliation for single-ventricle physiology, which we first performed in the setting of unfavourable upper-body systemic venous anatomy for a standard bi-directional Glenn, and in lieu of leaving our patient with shunt-dependent physiology. After an initial 16-month satisfactory follow-up, increasing cyanosis led to the discovery of a veno-venous collateral that was coiled, but, more importantly, to impressive growth of a previously diminutive superior caval vein, which allowed us to perform completion Fontan with a good outcome. Performing the single-ventricle staging in a reverse manner, first from below with a primary inferior cavopulmonary connection, followed by Fontan completion from above with a standard superior caval vein bi-directional Glenn, is also possible when deemed necessary.
authors: 1Department of Pediatrics,University of Mississippi Medical Center,Jackson,Mississippi,United States of America.
authors: Jannika
authors: J
authors: Dodge-Khatami
authors: 2Division of Pediatric Cardiology,University of Mississippi Medical Center,Jackson,Mississippi,United States of America.
authors: Avichal
authors: A
authors: Aggarwal
authors: 2Division of Pediatric Cardiology,University of Mississippi Medical Center,Jackson,Mississippi,United States of America.
authors: Mary B
authors: MB
authors: Taylor
authors: 4Department of Anesthesia,University of Mississippi Medical Center,Jackson,Mississippi,United States of America.
authors: Douglas
authors: D
authors: Maposa
authors: 5Children's Heart Center,University of Mississippi Medical Center,Jackson,Mississippi,United States of America.
authors: Jorge D
authors: JD
authors: Salazar
authors: 5Children's Heart Center,University of Mississippi Medical Center,Jackson,Mississippi,United States of America.
authors: Ali
authors: A
authors: Dodge-Khatami
mesh_terms: D017023:Coronary Angiography; D018729:Fontan Procedure / Q000379:methods*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011651:Pulmonary Artery / Q000601:surgery; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000601:surgery
keywords: CHD; Fontan; Glenn