title: Modified total cavopulmonary shunt as a staged Fontan operation.
abstract: The left superior vena cava became occluded in an infant with hypoplastic left heart syndrome. After a bidirectional Glenn procedure, he presented with severe oxygen desaturation and right ventricular dysfunction; the left superior vena cava drained into the inferior vena cava through collateral veins. As salvage therapy, we created a modified total cavopulmonary shunt using only autologous tissue in which the right hepatic vein and inferior vena cava drained into the pulmonary artery via a lateral tunnel in the right atrium. Immediately after surgery, his oxygen saturation increased and right ventricular function improved.
authors.affiliation: 1 Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Hidetsugu
authors.initials: H
authors.lastname: Asai
authors.affiliation: 1 Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Tachibana
authors.affiliation: 1 Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Yasushige
authors.initials: Y
authors.lastname: Shingu
authors.affiliation: 2 Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kato
authors.affiliation: 1 Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Wakasa
authors.affiliation: 1 Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Matsui
mesh_terms: D018729:Fontan Procedure; D018610:Heart Bypass, Right / Q000379:methods*; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016278:Ventricular Function, Right
keywords: Azygos vein; Fontan procedure; Heart defects; Hepatic veins; Vena cava; congenital; inferior; superior