Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-10T07:34:41.616Z Has data issue: false hasContentIssue false
  • English
  • Français

Recanalisation of the left superior caval vein after Fontan procedure: not so rare complication: possibilities of percutaneous closure using various devices

Published online by Cambridge University Press:  04 April 2014

Jacek Kusa ,
Leslaw Szydlowski ,
Ewa Nowakowska  and
Agnieszka Skierska
Jacek Kusa*
Affiliation:
Department of Paediatric Cardiology, Medical University of Silesia, ul. Medyków, Poland
Leslaw Szydlowski
Affiliation:
Department of Paediatric Cardiology, Medical University of Silesia, ul. Medyków, Poland
Ewa Nowakowska
Affiliation:
Department of Paediatric Cardiology, Medical University of Silesia, ul. Medyków, Poland
Agnieszka Skierska
Affiliation:
Department of Paediatric Cardiology, Medical University of Silesia, ul. Medyków, Poland
*
Correspondence to: J. Kusa, Department of Paediatric Cardiology, Medical University of Silesia, 40-752 Katowice, ul. Medyków 16, Poland. Tel:+48 600 525 814; Fax:+48 32 2071854; E-mail: jkusa@poczta.onet.pl
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim: Evaluation of possibilities of percutaneous closure of recanalised left superior caval vein after total cavopulmonary connection. Methods and Results: We analysed 19 patients after total cavopulmonary connection catheterised because of a sudden increase of desaturation. In four of them, the recanalisation of the left superior caval vein was identified. For this reason, the balloon occlusion tests of the veins were made temporarily. In all cases, the haemodynamic status of patients did not change, and arterial oxygen saturation increased significantly. Thus, using different types of implants, these veins were closed effectively in all patients. During the short-term follow-up, the effectiveness of treatments and constantly maintaining a high level of saturation were confirmed. Conclusions: Meticulous investigation of unclear causes of desaturation in cyanotic patients after Fontan completion is necessary. Almost all causes of desaturation, including recanalised additional left superior caval vein, can be effectively treated percutaneously.

Keywords

Transcatheter interventionsingle ventricleleft superior vena cava
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 3 , March 2015 , pp. 485 - 490
Copyright
© Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Gewillig, M. The Fontan circulation. Heart 2005; 91: 839–846.Google Scholar
2. Ghanayem, NS, Berger, S, Tweddell, JS. Medical management of the failing Fontan. Pediatr Cardiol 2007; 28: 465–471.Google Scholar
3. McCrindle, BW, Williams, RV, Mitchell, PD, et al. Relationship of patient and medical characteristics to health status in children and adolescents after the Fontan procedure. Circulation 2006; 113: 1123–1129.Google Scholar
4. Sugiyama, H, Yoo, SJ, Williams, W, Benson, LN. Characterization and treatment of systemic venous to pulmonary venous collaterals seen after the Fontan operation. Cardiol Young 2003; 13: 424–430.Google Scholar
5. Motoki, N, Ohuchi, H, Miyazaki, A, Yamada, O. Clinical profiles of adult patients with single ventricular physiology. Circulation 2009; 73: 1711–1716.Google Scholar
6. Menon, SC, Dearani, JA, Cetta, F. Long-term outcome after atrioventricular valve surgery following modified Fontan operation. Cardiol Young 2011; 21: 83–88.Google Scholar
7. Karur, S, Mahima, J, Nanjappa, MC. Systemic venous collateral channel causing desaturation after bidirectional cavopulmonary anastomosis: percutaneous closure. Cardiol Young 2011; 21: 107–109.Google Scholar
8. Madan, N, Ellozy, S, Love, B. Transcatheter repair of Fontan baffle stenosis and fenestration in two patients using Cook Zenith aortic endografts. J Invasive Cardiol 2012; 24: E32–E34.Google ScholarPubMed
9. Hass, E, Shreef, A, Bumgarner, JM, Gillespie, MJ, Stouffer, GA. Simultaneous occurrence of a single coronary artery and persistent left superior vena cava. Am J Med Sci 2011; 341: 234–237.Google Scholar
10. Girisch, M, Sieverding, L, Rauch, R, et al. Recanalisation of bilateral superior vena cava after total cavopulmonary connection. Interventional occlusion with the Amplatzer VSD Occluder. Z Kardiol 2005; 94: 469–473.Google Scholar
11. Baslaim, G, Hussain, A. Persistent left superior vena cava remnant causing cyanosis in a post-Fontan patient. Ann Thorac Surg 2013; 95: 115–117.CrossRefGoogle Scholar
12. Recupero, A, Pugliatti, P, Rizzo, F, et al. Persistent left-sided superior vena cava: integrated noninvasive diagnosis. Echocardiography 2007; 24: 982–986.Google Scholar