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Off-pump connection of the hepatic to the azygos vein through a lateral thoracotomy for relief of arterio-venous fistulas after a Kawashima procedure

Published online by Cambridge University Press:  01 June 2008

Fatima E.F.G. Lopez ,
Freek van den Heuvel ,
Petronella G. Pieper ,
Tjalling W. Waterbolk  and
Tjark Ebels
Fatima E.F.G. Lopez
Affiliation:
Division of Cardiothoracic Surgery, University Medical Centre Groningen, Groningen, The Netherlands
Freek van den Heuvel
Affiliation:
Division of Cardiothoracic Surgery, University Medical Centre Groningen, Groningen, The Netherlands
Petronella G. Pieper
Affiliation:
Division of Cardiothoracic Surgery, University Medical Centre Groningen, Groningen, The Netherlands
Tjalling W. Waterbolk
Affiliation:
Division of Cardiothoracic Surgery, University Medical Centre Groningen, Groningen, The Netherlands
Tjark Ebels*
Affiliation:
Division of Cardiothoracic Surgery, University Medical Centre Groningen, Groningen, The Netherlands
*
Correspondence to: T. Ebels MD, Ph, Department Cardiothoracic Surgery, University Medical Centre Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands. Tel: +31-503613238; Fax: +31-503611347; E-mail: T.Ebels@thorax.umcg.nl
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Abstract

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.

Conclusion

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.

Keywords

Extracorporeal cardiopulmonary bypasssurgical approachleft isomerismrelapsing cyanosis
Type
Original Article
Information
Cardiology in the Young , Volume 18 , Issue 3 , June 2008 , pp. 311 - 315
Copyright
Copyright © Cambridge University Press 2008

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