Redirection of Hepatic Drainage for Treatment of Pulmonary Arteriovenous Malformations Following the Fontan Procedure |
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Authors: | I -Hui Wu Khanh H Nguyen |
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Institution: | (1) Department of Cardiothoracic Surgery, Mount Sinai School of Medicine, One Gustave L. Levy Place, PO Box 1028, New York, NY 10029, USA |
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Abstract: | The development of unilateral pulmonary arteriovenous malformations in patients after total cavopulmonary connection with
an extracardiac conduit has been reported. Unequal distribution of hepatic venous flow to the lung is theorized to be the
causative factor. We report the surgical management of pulmonary arteriovenous malformations in a patient with heterotaxy
syndrome, single ventricle, and interrupted inferior vena cava. The patient had previously undergone a total cavopulmonary
connection with an extracardiac conduit draining hepatic venous flow to the right branch pulmonary artery. In the subsequent
operation, we redirected the extracardiac conduit to the innominate vein. This operation provided the affected lung with hepatic
venous blood without exposing the patient to the morbidity associated with cardiopulmonary bypass. |
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Keywords: | Cardiopulmonary bypass Pulmonary arteriovenous malformations Fontan procedure |
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