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Right arrow Congenital - cyanotic

Ann Thorac Surg 2003;75:1640-1642
© 2003 The Society of Thoracic Surgeons

Case report

New approach to the surgical management of pulmonary arteriovenous malformations after cavopulmonary anastomosis

Jay Steinberg, DOa*, George M. Alfieris, MDa, Berkeley Brandt, III, MDa, Frank Smith, MDa, Craig J. Byrum, MDa, Gregory W. Fink, MDa, Jeffrey Halter, MDa

a Departments of Cardiovascular Surgery and Pediatric Cardiology, SUNY Upstate Medical University, Syracuse, New York, USA

Accepted for publication November 13, 2002.

* Address reprint requests to Dr Steinberg, Department of Surgery, SUNY Upstate Medical University, 750 East Adams St, Syracuse, NY 13210, USA
e-mail: steinbja{at}upstate.edu

The development of pulmonary arteriovenous malformations after cavopulmonary bypass in patients with congenital heart disease is well documented. We report successful management of pulmonary arteriovenous malformations after cavopulmonary bypass in a patient with an interrupted inferior vena cava (IVC) and multiple hepatic veins utilizing an extracardiac conduit from the hepatic veins to the hemiazygous continuation of the interrupted IVC. This technique, performed without circulatory arrest or an atriotomy, may limit morbidity associated with intracardiac procedures in patients with single ventricle morphology. Furthermore, this case suggests an alternative technique for completion Fontan in patients with an interrupted IVC and multiple hepatic venous drainage.




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