Document Detail


Thrombosis of intracardiac or extracardiac conduits after modified Fontan operation in patients with azygous continuation of the inferior vena cava.
MedLine Citation:
PMID:  11722058     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The Fontan procedure in patients with azygous continuation of the inferior vena cava, requires a cavo-pulmonary anastomosis, and deviation of the hepatic venous drainage to the pulmonary arteries using an intra- or extracardiac conduit. METHODS: We report thrombosis of two pericardial conduits and one Gore-Tex (W. L. Gore & Assoc, Flagstaff, AZ) graft used for deviation of hepatic venous blood to the pulmonary arterial tree in 3 patients aged 11, 24, and 28 years. Two of the conduits (pericardial) were intraatrial. The Gore-Tex graft was placed in an extracardiac position. The two pericardial conduits obstructed completely. RESULTS: One patient died at reoperation. In the 2nd patient, the conduit was excised and the hepatic veins were allowed to drain into the atrium. In the 3rd patient, partial thrombosis of the Gore-Tex conduit was noted 30 months after operation. The thrombus resolved with oral anticoagulation. CONCLUSIONS: Conduits carrying only hepatic venous blood flow may have a higher risk of thrombosis. Anticoagulation or alternative methods of directing hepatic blood flow to the pulmonary circulation must be considered in these patients.
Authors:
I E Konstantinov; F J Puga; V V Alexi-Meskishvili
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  72     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-11-27     Completed Date:  2002-01-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1641-4     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota 55902, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Azygos Vein / abnormalities*
Child
Female
Fontan Procedure / adverse effects*
Humans
Male
Thrombosis / etiology*
Vena Cava, Inferior / abnormalities*

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


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