Connecting hepatic vein and azygos vein by an autologous pericardial conduit to complete a Fontan procedure through a unilateral thoracotomy: A case report_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SHI Tao , GAO Zhan , TENG Xiao , YU Bing , LV Xiaodong ,  HUA Zhongdong

Pediatric Cardiac Surgery Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, P.R.China;

Corresponding author：

HUA Zhongdong, Email: clusterheadache@126.com

Keywords：

Single ventricle; interrupted inferior vena cava; unilateral thoracotomy; autologous pericardial conduit; hepatic vein-azygos vein connection

DOI：

10.7507/1007-4848.202005075

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We reported a case of a six-year-old boy diagnosed of single ventricle, pulmonary atresia and interrupted inferior vena cava. After modified Blalock-Taussig shunt and bidirectional Glenn procedure, he received the Fontan procedure. The Fontan procedure was done through a unilateral thoracotomy, using an autologous pericardial conduit to connect hepatic vein and azygos vein. The result of short-term follow-up was satisfactory.

Citation： SHI Tao, GAO Zhan, TENG Xiao, YU Bing, LV Xiaodong, HUA Zhongdong. Connecting hepatic vein and azygos vein by an autologous pericardial conduit to complete a Fontan procedure through a unilateral thoracotomy: A case report. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(9): 1130-1132. doi: 10.7507/1007-4848.202005075 Copy

1.	Kavarana MN, Jones JA, Stroud RE, et al. Pulmonary arteriovenous malformations after the superior cavopulmonary shunt: Mechanisms and clinical implications. Expert Rev Cardiovasc Ther, 2014, 12(6): 703-713.
2.	Montesa C, Karamlou T, Ratnayaka K, et al. Hepatic vein incorporation into the azygos system in heterotaxy and interrupted inferior vena cava. World J Pediatr Congenit Heart Surg, 2019, 10(3): 330-337.
3.	Lopez FE, van den Heuvel F, Pieper PG, et al. Off-pump connection of the hepatic to the azygos vein through a lateral thoracotomy for relief of arterio-venous fistulas after a Kawashima procedure. Cardiol Young, 2008, 18(3): 311-315.
4.	Arrigoni SC, van den Heuvel F, Willems TP, et al. Off-pump hepatic to azygos connection via thoracotomy for relief of fistulas after a Kawashima procedure: Ten-year results. J Thorac Cardiovasc Surg, 2015, 149(6): 1524-1530.
5.	McElhinney DB, Marx GR, Marshall AC, et al. Cavopulmonary pathway modification in patients with heterotaxy and newly diagnosed or persistent pulmonary arteriovenous malformations after a modified Fontan operation. J Thorac Cardiovasc Surg, 2011, 141(6): 1362-1370.
6.	Amodeo A, Di Carlo D, Grigioni M, et al. Early primary Kawashima operation combined with direct hepatic vein-to-azygos vein connection: A new logical approach. J Thorac Cardiovasc Surg, 2005, 129(4): 949-950.
7.	Setyapranata S, Brizard CP, Konstantinov IE, et al. Should we always plan a Fontan completion after a Kawashima procedure? Eur J Cardiothorac Surg, 2011, 40(4): 1011-1015.
8.	Kido T, Hoashi T, Shimada M, et al. Clinical outcomes of early scheduled Fontan completion following Kawashima operation. Gen Thorac Cardiovasc Surg, 2017, 65(12): 692-697.
9.	Adachi I, Ishibashi-Ueda H, Yagihara T, et al. Immunohistologic examination of pedicled autologous pericardium 9 years after implantation for an extracardiac conduit in Fontan pathway: Comparison with in situ pericardium and pulmonary arterial tissue from the same patient. J Thorac Cardiovasc Surg, 2007, 133(4): 1101-1103.
10.	Masaki N, Adachi O, Kawamoto S, et al. Implanted pedicled autologous pericardium mimics vasculature tissue: Case report. J Thorac Cardiovasc Surg, 2017, 153(1): e11-e13.

1. Kavarana MN, Jones JA, Stroud RE, et al. Pulmonary arteriovenous malformations after the superior cavopulmonary shunt: Mechanisms and clinical implications. Expert Rev Cardiovasc Ther, 2014, 12(6): 703-713.
2. Montesa C, Karamlou T, Ratnayaka K, et al. Hepatic vein incorporation into the azygos system in heterotaxy and interrupted inferior vena cava. World J Pediatr Congenit Heart Surg, 2019, 10(3): 330-337.
3. Lopez FE, van den Heuvel F, Pieper PG, et al. Off-pump connection of the hepatic to the azygos vein through a lateral thoracotomy for relief of arterio-venous fistulas after a Kawashima procedure. Cardiol Young, 2008, 18(3): 311-315.
4. Arrigoni SC, van den Heuvel F, Willems TP, et al. Off-pump hepatic to azygos connection via thoracotomy for relief of fistulas after a Kawashima procedure: Ten-year results. J Thorac Cardiovasc Surg, 2015, 149(6): 1524-1530.
5. McElhinney DB, Marx GR, Marshall AC, et al. Cavopulmonary pathway modification in patients with heterotaxy and newly diagnosed or persistent pulmonary arteriovenous malformations after a modified Fontan operation. J Thorac Cardiovasc Surg, 2011, 141(6): 1362-1370.
6. Amodeo A, Di Carlo D, Grigioni M, et al. Early primary Kawashima operation combined with direct hepatic vein-to-azygos vein connection: A new logical approach. J Thorac Cardiovasc Surg, 2005, 129(4): 949-950.
7. Setyapranata S, Brizard CP, Konstantinov IE, et al. Should we always plan a Fontan completion after a Kawashima procedure? Eur J Cardiothorac Surg, 2011, 40(4): 1011-1015.
8. Kido T, Hoashi T, Shimada M, et al. Clinical outcomes of early scheduled Fontan completion following Kawashima operation. Gen Thorac Cardiovasc Surg, 2017, 65(12): 692-697.
9. Adachi I, Ishibashi-Ueda H, Yagihara T, et al. Immunohistologic examination of pedicled autologous pericardium 9 years after implantation for an extracardiac conduit in Fontan pathway: Comparison with in situ pericardium and pulmonary arterial tissue from the same patient. J Thorac Cardiovasc Surg, 2007, 133(4): 1101-1103.
10. Masaki N, Adachi O, Kawamoto S, et al. Implanted pedicled autologous pericardium mimics vasculature tissue: Case report. J Thorac Cardiovasc Surg, 2017, 153(1): e11-e13.

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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Connecting hepatic vein and azygos vein by an autologous pericardial conduit to complete a Fontan procedure through a unilateral thoracotomy: A case report

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