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Yuji Hiramatsu
Mio Noma
Yuzuru Sakakibara
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Right arrow Congenital - cyanotic
Asian Cardiovasc Thorac Ann 2006;14:e6-e8
© 2006 Asia Publishing EXchange Ltd

CASE STUDIES

A Pitfall in Ligation of Intrahepatic Shunting after Fontan Type Operation

Akihiko Ikeda, MD, Yuji Hiramatsu, MD, Hitoshi Horigome, MD1, Tetsuo Hori, MD2, Mio Noma, MD, Yuzuru Sakakibara, MD

Department of Cardiovascular Surgery
1 Department of Pediatric Cardiology
2 Department of Pediatric Surgery, University of Tsukuba, Tsukuba, Japan

For reprint information contact: Yuji Hiramatsu, MD, Tel: 81 29 853 3096, Fax: 81 29 853 3096, Email: yuji3{at}md.tsukuba.ac.jp, Department of Cardiovascular Surgery, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan.

An 8-year-old boy experienced progressive cyanosis after a Fontan type operation. Under the guidance of intraoperative color Doppler we performed a transabdominal ligation of the accessory hepatic veins which drained into a common atrium. Reoperation was needed through a median sternotomy to eliminate residual shunting. Although intraoperative Doppler is useful to aid in the ligation of accessory veins while portal hypertension is monitored, intraoperative angiogram serves better to ensure the elimination of intrahepatic shunting in a transabdominal approach.






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