Fontan completion in reverse order out of necessity: secondary Glenn after primary extracardiac inferior cavopulmonary artery connection

Cardiol Young. 2017 Jul;27(5):925-928. doi: 10.1017/S1047951116001839. Epub 2016 Oct 28.

Abstract

The primary extracardiac inferior cavopulmonary connection is an unusual novel palliation for single-ventricle physiology, which we first performed in the setting of unfavourable upper-body systemic venous anatomy for a standard bi-directional Glenn, and in lieu of leaving our patient with shunt-dependent physiology. After an initial 16-month satisfactory follow-up, increasing cyanosis led to the discovery of a veno-venous collateral that was coiled, but, more importantly, to impressive growth of a previously diminutive superior caval vein, which allowed us to perform completion Fontan with a good outcome. Performing the single-ventricle staging in a reverse manner, first from below with a primary inferior cavopulmonary connection, followed by Fontan completion from above with a standard superior caval vein bi-directional Glenn, is also possible when deemed necessary.

Keywords: CHD; Fontan; Glenn.

Publication types

  • Case Reports

MeSH terms

  • Coronary Angiography
  • Fontan Procedure / methods*
  • Heart Defects, Congenital / diagnostic imaging*
  • Heart Defects, Congenital / surgery*
  • Heart Ventricles / surgery
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Pulmonary Artery / surgery
  • Treatment Outcome
  • Vena Cava, Superior / surgery