Percutaneous closure of a large iatrogenic fistula between the inferior vena cava and the pulmonary vein in a child

Abstract

We hereby describe a complex late postoperative veno-venous fistula in a child, successfully treated by an interventional percutaneous procedure. It is a unique complication of diaphragmatic hernia surgery that has never been reported before: a late postoperative iatrogenic fistula, between the inferior vena cava and the right lower pulmonary vein, discovered in a 6-year-old boy operated at the age of 4 months for a right diaphragmatic hernia. The right to left shunt was completely and uneventfully suppressed by a percutaneous procedure separating the systemic venous return from the pulmonary venous return with an Amplatzer Vascular Plug II.

Acquired systemic-to-pulmonary shunts in a 6-month-old child: case report and review of the literature

“…Only one case was described in a child secondary to a thoracic surgery. 6 These acquired right to left shunts are well known in the CHD population, in particular, in patients with Fontan circulation. 5,7 It can reach more than 50% of those patients with essential collaterals located above the diaphragm that are the result of recanalisation of embryological venous collaterals also known as bronchial venous plexuses.…”

Catheter closure of a recanalized vertical vein after repair of total anomalous pulmonary venous connection

“…Additionally, it clearly defined the target landing zone, confirming the patency of PVR to the left atrium and the left internal jugular vein to the LIV during balloon occlusion (Fig. ) . The occluding device is generally selected according to the size, anatomy, the presence of tapered segments and the hemodynamic characteristics of the vascular malformation.…”