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Fontan conversion with hepatic vein exclusion: a means for hepatic preservation in single ventricle heart disease

Published online by Cambridge University Press:  03 July 2015

Brian Kogon*
Affiliation:
Department of Cardiothoracic Surgery, Emory University, Atlanta, Georgia, United States of America
Michael McConnell
Affiliation:
Sibley Heart Center Cardiology, Children’s Healthcare of Atlanta, Atlanta, Georgia, United States of America
Wendy Book
Affiliation:
Department of Cardiology, Emory University, Atlanta, Georgia, United States of America
*
Correspondence to: B. E. Kogon, MD, Department of Pediatric Cardiothoracic Surgery, Children’s Healthcare of Atlanta, Emory University, Egleston 1405 Clifton Road NE Atlanta, Georgia, United States of America. Tel: +404 785 6319; Fax: +404 785 6265; E-mail: Bkogon@emory.edu

Abstract

Patients with single ventricle heart disease often undergo staged surgical palliation, ultimately resulting in Fontan anatomy and physiology. Long-term consequences include cirrhosis of the liver, protein-losing enteropathy, and premature death. Elevated central venous pressure and venous congestion transmitted to the abdominal viscera have been implicated in the aetiology of many of these complications. We present a novel operation directed at protecting the liver and intestines by excluding the splanchnic venous return from the Fontan pathway. Instead of exposure to elevated Fontan pressures, the liver and intestines will be exposed to lower common atrial pressures. We hope that this modification will minimise the abdominal complications of Fontan anatomy and physiology.

Type
Brief Reports
Copyright
© Cambridge University Press 2015 

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