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Percutaneous Closure of a Large Unligated Vertical Vein Using the Amplatzer Vascular Plug II After Supracardiac Total Anomalous Pulmonary Venous Connection (TAPVC) Repair
Authors:Vimalarani Devendran  Neil Wilson  Vimala Jesudian
Institution:1. Department of Pediatric Cardiology, Institute of Cardiovascular Diseases, The Madras Medical Mission, 4A, Dr. J. J. Nagar, Mogappair, Chennai, 600037, India
2. John Radcliffe Hospital, Oxford, UK
Abstract:It is well known that the vertical vein (VV) may have to be left open after repair of a total anomalous pulmonary venous connection (TAPVC) in children with preoperative obstruction, whose left heart chambers are small (Cope et al. in Ann Thorac Surg 64:23–29, 3). An unligated VV has been found to reduce pulmonary arterial pressure, decrease perioperative pulmonary hypertensive crisis, and provide better hemodynamics postoperatively (Chowdhry et al. in J Thorac Cardiovasc Surg 133:1286–1294, 2). Although these VVs are expected to close later, they may remain patent in about half of these children (Cheung et al. J Paediatr Child Health 41:361–364, 1).The patent VVs may be a cause for significant left-to-right shunting, and the children may be symptomatic. The case report describes a child who had a large patent VV after repair of supracardiac TAPVC and its closure using the Amplatzer Vascular Plug II device.
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