2010
DOI: 10.1017/s104795111000140x
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Systemic venous collateral channel causing desaturation after bidirectional cavopulmonary anastomosis: percutaneous closure

Abstract: An infant with cyanotic cardiac disease that was palliated with a bidirectional cavopulmonary shunt developed progressive and worsening cyanosis 5 years after the surgical procedure. A large venous collateral was found to be decompressing the bidirectional Glenn shunt from the superior caval vein to the inferior caval vein and was percutaneously closed with a vascular plug. The unusually large venous collateral, and the excellent outcome associated with percutaneous procedure are discussed.

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Cited by 5 publications
(11 citation statements)
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“…[7][8][9] Depending on where these collaterals originate and drain, they typically are a source of right-to-left shunting, resulting in cyanosis. 10,11 Although technically feasible, occlusion of these collaterals in the early postoperative period did not improve patient outcome in our study, as the transplant-free survival to discharge for patients with venovenous collaterals who underwent collateral occlusion was similar to that for patients who did not undergo occlusion (40% vs 50%, respectively). This is likely due to the fact that early postoperative development of venovenous collaterals leading to prohibitive cyanosis is a result of failing stage II physiology.…”
Section: Commentmentioning
confidence: 54%
See 1 more Smart Citation
“…[7][8][9] Depending on where these collaterals originate and drain, they typically are a source of right-to-left shunting, resulting in cyanosis. 10,11 Although technically feasible, occlusion of these collaterals in the early postoperative period did not improve patient outcome in our study, as the transplant-free survival to discharge for patients with venovenous collaterals who underwent collateral occlusion was similar to that for patients who did not undergo occlusion (40% vs 50%, respectively). This is likely due to the fact that early postoperative development of venovenous collaterals leading to prohibitive cyanosis is a result of failing stage II physiology.…”
Section: Commentmentioning
confidence: 54%
“…7 9 Depending on where these collaterals originate and drain, they typically are a source of right-to-left shunting, resulting in cyanosis. 10,11…”
Section: Resultsmentioning
confidence: 99%
“…In other cases, it results from abnormal formation of patency of vascular connections, as, for example, pulmonary arterio-venous fistulas or less frequentlycollaterals between systemic veins and pulmonary veins or pulmonary venous atrium. 3,4,7,8 During the embryological development of the venous system, the involution of left cardinal vein occurs, resulting in an exclusively right-sided superior caval vein. However, in some subjects, the persistence of left superior caval vein occurs: in 0.3% of the population with normal cardiovascular system and in about 5% of the population with congenital cardiac anomalies.…”
Section: Discussionmentioning
confidence: 99%
“…In other cases, it results from abnormal formation of patency of vascular connections, as, for example, pulmonary arterio-venous fistulas or less frequently – collaterals between systemic veins and pulmonary veins or pulmonary venous atrium 3 4 , 7 , 8…”
Section: Discussionmentioning
confidence: 99%
“…Systemic venous collaterals may be present if an inordinate amount of hypoxemia occurs in the absence of pulmonary factors, poor systemic blood flow or relative anemia. Systemic venous collaterals allow blood in upper body veins to circumvent the pulmonary circulation and return to the heart through venous connections with the inferior vena cava or pulmonary veins [1][2][3][4][5]. Large collaterals result in unacceptably low oxygen saturation measurements early after palliation.…”
Section: Introductionmentioning
confidence: 99%