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First-in-man transcatheter Fontan completion in post Kawashima patient after successful recruiting of separately draining hepatic veins — A case report

Published online by Cambridge University Press:  10 July 2025

Muthukumaran Chinnasamy Sivaprakasam ,
Rajaguru Ganesan Open the ORCID record for Rajaguru Ganesan [Opens in a new window] ,
Anuradha Sridhar  and
Zeeshan S. Lakhani
Muthukumaran Chinnasamy Sivaprakasam*
Affiliation:
Apollo Children’s Hospital, Department of Pediatric Cardiology, Chennai, India
Rajaguru Ganesan
Affiliation:
Apollo Children’s Hospital, Department of Pediatric Cardiology, Chennai, India
Anuradha Sridhar
Affiliation:
Apollo Children’s Hospital, Department of Pediatric Cardiology, Chennai, India
Zeeshan S. Lakhani
Affiliation:
Apollo Hospitals, Department of Radiology, Chennai, India
*
Corresponding author: M. Chinnasamy Sivaprakasam; Email: ach.paedcardio@gmail.com
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Abstract

Background:

Heterotaxy patients after Kawashima surgery, with separately draining hepatic veins pose a complexity for Fontan completion. We describe a novel percutaneous technique for hepatic vein diversion and complete transcatheter Fontan.

Case report:

A 6-year-old female with single ventricle physiology and bilateral hepatic vein drainage underwent Kawashima surgery. She later developed a complete heart block and elevated mean pulmonary pressures (17 mmHg). Permanent pacemaker implantation and left hepatic vein ligation were performed. Due to elevated pulmonary pressures, transcatheter Fontan completion was chosen over surgical options, and hepatic veins were included without prior surgical preparation as there were well-developed venous collaterals between the hepatic veins. The patient remained asymptomatic post-intervention with no complications and was discharged on anticoagulation therapy.

Keywords

Transcatheter fontanKawashimahepatic vein ligation

Information

Type
Brief Report
Information
Cardiology in the Young , First View , pp. 1 - 4
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Copyright
© The Author(s), 2025. Published by Cambridge University Press

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References

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