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When the bi-directional Glenn is an unfavourable option: primary extracardiac inferior cavopulmonary connection as an alternative palliation

Published online by Cambridge University Press:  28 April 2015

Ali Dodge-Khatami*
Affiliation:
Division of Pediatric and Congenital Heart Surgery, University of Mississippi Medical Center, Jackson, Mississippi, USA
Avichal Aggarwal
Affiliation:
Division of Pediatric and Fetal Cardiology, University of Mississippi Medical Center, Jackson, Mississippi, USA
Mary B. Taylor
Affiliation:
Division of Pediatric and Fetal Cardiology, University of Mississippi Medical Center, Jackson, Mississippi, USA Division of Pediatric Critical Care, University of Mississippi Medical Center, Jackson, Mississippi, USA
Douglas Maposa
Affiliation:
Division of Pediatric Anesthesiology, The Children’s Heart Center, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
Jorge D. Salazar
Affiliation:
Division of Pediatric and Congenital Heart Surgery, University of Mississippi Medical Center, Jackson, Mississippi, USA
*
Correspondence to: Dr A. Dodge-Khatami, MD, PhD, Chief, Division of Pediatric and Congenital Heart Surgery, Children’s Heart Center, Professor of Surgery, University of Mississippi Medical Center, 2500 North State Street, Room S345, Jackson, MS 39216, United States of America. Tel: +(601) 984 4693; Fax: +(601) 984 5872; E-mail: adodgekhatami@umc.edu

Abstract

The superior cavopulmonary anastomosis – bi-directional Glenn – is the standard palliation for single ventricle physiology. When upper body systemic venous anatomic concerns such as superior caval vein stenosis, hypoplasia, or inadequate collateral tributaries are present, a Glenn may be precluded or have a high risk of poor outcome. A primary inferior cavopulmonary connection with an extracardiac conduit is an alternative palliation that provides a generous pathway for pulmonary blood flow, with the additional benefit of including hepatic venous return. We report a case of primary extracardiac inferior cavopulmonary connection in a patient unsuitable for Glenn, with successful post-operative outcome and early follow-up.

Keywords

Type
Original Articles
Copyright
© Cambridge University Press 2015 

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References

1. Pridjian, AK, Mendelsohn, AM, Lupinetti, FM, et al. Usefulness of the bidirectional Glenn procedure as staged reconstruction for the functional single ventricle. Am J Cardiol 1993; 71: 959962.Google Scholar
2. Bernstein, HS, Brook, MM, Silverman, NH, Bristow, J. Development of pulmonary arteriovenous fistulae in children after cavopulmonary shunt. Circulation 1995; 92 (Suppl): II309II314.CrossRefGoogle ScholarPubMed
3. Knight, WB, Mee, RBB. A cure for pulmonary arteriovenous fistulas? Ann Thorac Surg 1995; 59: 9991001.Google Scholar
4. Iyer, GK, Van Arsdell, GS, Dicke, FP, McCrindle, BW, Coles, JG, Williams, WG. Are bilateral superior vena cavae a risk factor for single ventricle palliation? Ann Thorac Surg 2000; 70: 711716.Google Scholar
5. Macé, L, Dervanian, P, Losay, J, et al. Bidirectional inferior vena cava-pulmonary artery shunt. Ann Thorac Surg 1997; 63: 13211325.Google Scholar