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Ann Thorac Surg 2004;78:697-699
© 2004 The Society of Thoracic Surgeons

Case report

Regression of severe pulmonary arteriovenous malformations after Fontan revision and "hepatic factor" rerouting

Nancy A. Pike, RN, FNPa*, Luca A. Vricella, MDa, Jeffrey A. Feinstein, MDb, Michael D. Black, MDb, Bruce A. Reitz, MDb

a Division of Cardiothoracic Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA
b Division of Cardiothoracic Surgery, Pediatric Cardiology, Lucile Packard Children's Hospital at Stanford, Stanford University School of Medicine, Stanford, California, USA

Accepted for publication October 2, 2003.

* Address reprint requests to Ms Pike, Cardiothoracic Surgery, David Geffen School of Medicine, UCLA, Box 951741, Los Angeles, CA 90095-1741, USA
e-mail: npike{at}mednet.ucla.edu

Although previously described in patients undergoing staged palliation for univentricular heart disease, the mechanism by which hepatic venous flow prevents development of pulmonary arteriovenous malformations is still not completely understood. We present a case in which successful H-type Fontan revision with rerouting of hepatic venous flow through a hemiazygous vein successfully reversed the progression of severe left pulmonary arteriovenous malformations.




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