Document Detail


Accessory hepatic vein complicating extra-cardiac total cavopulmonary connection.
MedLine Citation:
PMID:  12027800     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We encountered unexpected, severe hypoxia after the right heart bypass operation in a patient with isomerism. A 2-year-old girl with polysplenia had a complex cardiac anomaly consisting of a single atrium, single ventricle, pulmonary stenosis, absence of the right superior vena cava, hemiazygos continuation of the left inferior vena cava, and d-malposition of the great arteries. After a total cavopulmonary shunt, we performed an extra-cardiac total cavo-pulmonary connection with a 14 mm tube graft. The postoperative course was complicated by severe hypoxia. Angiography performed 20 days after the operation showed that contrast medium in the conduit poured into the hepatic vein, and through the intrahepatic communications, it passed into a left-sided accessory hepatic vein, which was connected directly to the left side of the aspect of the atrium. As the intrahepatic communication was adequate, we ligated the accessory hepatic vein within the pericardial cavity. The SpO2 returned to normal and no hepatic dysfunction was detected. We conclude that surgeons performing extra-cardiac total cavopulmonary connection need to pay closer attention to the possibility that an accessory hepatic vein might exist.
Authors:
Shinpei Yoshii; Shoji Suzuki; Hiroshi Osawa; Shigeru Hosaka; Yoshihiro Honda; Samuel J K Abraham; Yusuke Tada; Hisashi Sugiyama; Tetsushi Tan; Toshie Kadono; Minako Hoshiai; Takayuki Komai
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia     Volume:  8     ISSN:  1341-1098     ISO Abbreviation:  Ann Thorac Cardiovasc Surg     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-05-24     Completed Date:  2002-07-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9703158     Medline TA:  Ann Thorac Cardiovasc Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  112-4     Citation Subset:  IM    
Affiliation:
Department of Surgery, Yamanashi Medical University, Tamaho-cho, Nakakoma-gun, Japan.
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MeSH Terms
Descriptor/Qualifier:
Anoxia / etiology
Child, Preschool
Female
Heart Bypass, Right* / adverse effects
Heart Defects, Congenital / complications,  surgery
Hepatic Veins / abnormalities*,  radiography,  surgery*
Humans
Isomerism
Postoperative Complications / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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