Trans catheter device closure of a large azygos vein in adult patient with systemic venous collateral development after the bidirectional Glenn shunt

Khajali, Zahra; Firouzi, Ata; Pashapour, Pooneh; Ghaderian, Homa

doi:10.34172/jcvtr.2021.14

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…Patients who have pressures >15 mmHg have to be tested first by balloon test occlusion. A sizing balloon has to be placed to totally occlude the collateral for 15 minutes, then the pressures and saturations are to be re-measured ( 12 ). The sizes of the collaterals, morphology, and accessibility are the most important determinant factors in the selection of the closure technique.…”

Section: Technical Aspects Of Transcatheter Closure Of Veno-venous Co...mentioning

confidence: 99%

Catheter interventional closure of veno-venous collaterals in cyanotic patients after partial cavopulmonary shunts in pediatric patients: clinical practice review

Abdelaziz¹,

Tanase²,

Ewert³

et al. 2023

Cardiovasc Diagn Ther

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The development of veno-venous collaterals is an important and treatable cause of cyanosis in patients who had undergone partial cavo-pulmonary connection (PCPC) operations. Nevertheless, the literature on this complicated therapeutic option is sparse. Patients can present cyanosis either immediately after the operation (<30 days), which delays or hinders discharge from the intensive care unit or cyanosis may occur late: (>30 days and/or in another hospital admission), after the operation. Hence, transcatheter closure of veno-venous collaterals is the treatment of choice. Four patients were selected who showed cyanosis at variable durations after PCPC; the morphology of the collaterals and their hemodynamic effect was described and the strategy for closure of such abnormal vessels is suggested. Veno-venous collaterals described in our series were seen originating mainly or mostly from innominate vein angles. The drainage sites were either above the diaphragm into a cardiac structure: the coronary sinus (CS) and/or atria; or below the diaphragm into the inferior vena cava (IVC) or hepatic veins through the paravertebral venous system and/or the azygous system. It is stated in the literature that several types of devices and coils can be used to close the collaterals such as the Amplatzer vascular plugs (AVPs), Amplatzer duct occluder II (ADOII), non-detachable and detachable coils. In this clinical review, the technical details that determine device type and size are explained. The recent generations of hydrogel-coated coils were also used in this series of patients to close the difficult types of collaterals with better results. All described vessels were closed successfully, without any complications. The patients had a significant rise in their transcutaneous oxygen saturations and hence, a clear clinical benefit.

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Section: Technical Aspects Of Transcatheter Closure Of Veno-venous Co...mentioning

confidence: 99%