Transcatheter Hepatic Conduit-Azygous Vein Connection Reduces Pulmonary Arteriovenous Malformations in a Cyanotic Fontan Patient

Kanishka Ratnayaka; Zhenglun A Wei; Justin R Ryan; Caitlin M Heyden; Hari K Narayan; Timothy C Slesnick; Robert J Lederman; John W Moore; Ajit P Yoganathan; Howaida G El-Said

doi:10.1016/j.jaccas.2023.101760

Transcatheter Hepatic Conduit-Azygous Vein Connection Reduces Pulmonary Arteriovenous Malformations in a Cyanotic Fontan Patient

JACC Case Rep. 2023 Mar 15:10:101760. doi: 10.1016/j.jaccas.2023.101760.

Authors

Affiliations

¹ Department of Pediatric Cardiology, Rady Children's Hospital, University of California-San Diego, San Diego, California, USA.
² Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA.
³ Department of Biomedical Engineering, University of Massachusetts Lowell, Lowell, Massachusetts, USA.
⁴ Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA.
⁵ Webster Foundation 3D Innovations Lab, Rady Children's Hospital, Department of Neurological Surgery, University of California-San Diego, San Diego, California, USA.
⁶ Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.

Abstract

The authors report a closed-chest, transcatheter large-vessel connection (hepatic conduit to azygous vein) to reverse pulmonary arteriovenous malformations in a 10-year-old patient after Fontan for heterotaxy/interrupted inferior vena cava, with an increase in oxygen saturation from 78% to 96%. Computational fluid dynamics estimated a 14-fold increase in hepatic blood flow to the left pulmonary artery (from 1.3% to 14%). (Level of Difficulty: Advanced.).

Keywords: Kawashima; congenital heart disease; heterotaxy/interrupted IVC; transcatheter electrosurgery.

Publication types

Case Reports