Atriopulmonary anastomosis

Kreutzer, Guillermo; Vargas, Florentino J.; Schlichter, Andrés J.; Laura, Juan P.; Suárez, José; Coronel, Alberto Rodríguez; Kreutzer, Eduardo A.

doi:10.1016/s0022-5223(19)37280-0

Cited by 116 publications

(20 citation statements)

References 15 publications

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“…The Fontan procedure was introduced for a functional single ventricle more than 40 years ago, [1,2] and it has undergone several major technical modifications. [3] However, in patients with risk factors such as pulmonary artery pressure (PAP) >18 mmHg, end-diastolic pressure >12 mmHg, valvar regurgitation, pulmonary artery distortion, pulmonary vascular resistance >2 Woods’ units, ventricular outflow obstruction, and complex anatomy, the postoperative mortality rate with this procedure remained high because of elevated systemic venous pressure and decreased cardiac output.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the fenestrated and non-fenestrated Fontan procedures

Li¹,

Zhou

et al. 2019

Medicine

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Section: Introductionmentioning

confidence: 99%

Comparison of the fenestrated and non-fenestrated Fontan procedures

Li¹,

Zhou

et al. 2019

Medicine

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“…Currently, serial circulation is obtained in two stages: first an end-to-side anastomosis of the superior vena cava to the right branch of the pulmonary artery (modified Glenn procedure); in the second stage, the interposition of a tube between the inferior vena cava and the pulmonary artery achieves complete diversion of the systemic venous flow. [1][2][3][4][5] Most patients with univentricular heart require a palliative procedure prior to Glenn operation. Cerclage of the pulmonary artery is indicated in cases of excess pulmonary flow, to avoid pulmonary hypertension incompatible with the CPS.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 In a second surgery, the flow of the inferior vena cava is diverted by the interposition of a tube between this vein and the right pulmonary artery, completing the total shunt of the systemic venous flow, without a ventricular chamber (modified Fontan procedure). [3][4][5] Several anatomical complications can occur in the follow -up of patients that have undergone CPS, which affect the delicate balance of a circulation that has little reserve to cope with pressure or volume overloads. [6][7][8][9][10] The percutaneous treatment of obstructive lesions or deleterious shunts, considering the use of regular devices, is an essential resource to restore appropriate physiological conditions, therefore improving quality of life, prolonging survival, and either avoiding new surgical interventions or enabling them to be conducted under more favorable clinical conditions.…”

Section: Introductionmentioning

confidence: 99%

Interventional therapeutic procedures in cavopulmonary shunts

Oliveira¹,

Haddad²,

Pavão³

et al. 2018

J Transcat Intervent

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Background Cavopulmonary shunts are the palliative surgeries of choice in congenital heart diseases with the anatomical and pathophysiological defect of univentricular heart. The objective of this study was to report the results of percutaneous procedures in patients with complications following partial or total surgical cavopulmonary shunts. Methods: The procedures were conducted under general anesthesia and continuous monitoring of hemodynamic and respiratory parameters. The accesses used were the femoral vein (Fontan) or the internal jugular vein (Glenn). The devices were those commonly used for treating vascular obstructions, occlusion of venovenous or arteriovenous shunts, and systemic-pulmonary anastomoses. Results: Ten procedures were conducted in ten patients; in that, four Glenn (Group I) and six Fontan (Group II). The mean age in Groups I and II was 86 months and 106 months, and the mean time since surgery was 24 months and 25 months, respectively. Six patients had obstructive lesions and four had venovenous shunts, systemic-pulmonary anastomosis or a fenestrated cavopulmonary tube. In cases with obstructive lesions, there was no residual gradient; after dilation, there was a significant increase or normalization of vessel diameter. In patients with shunts, there was complete occlusion after deployment of the device. In all cases hemodynamic parameters normalized, clinical status improved and there were no complications. Conclusions: Percutaneous procedures are safe and effective to treat obstructive lesions or shunts in patients with a history of cavopulmonary shunt and presenting such complications.

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“…A operação tipo Fontan-Kreutzer (KREUTZER et alii 14) , foi proposta para a correção paliativa de cardiopatias congênitas complexas, onde não seria possível o aproveitamento de ambos os ventrículos.…”

Section: Comentáriosunclassified

Avaliação dos resultados tardios da operação de derivação cavo-pulmonar bidirecional, no tratamento paliativo de cardiopatias congênitas com câmara ventricular única

Maluf

Andrade

Catani

et al. 1994

Rev Bras Cir Cardiovasc

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RBCCV 44205-236 I MALUF, M. A. ; ANDRADE, J. C. s.; CATANI, R.; CARVALHO, A. C.; NEGRINI , N.; BUFFOLO, E. -Avaliação dos resultados tardios da operação de derivação cavo-pulmonar bidirecional, no tratamento paliativo de cardiopatias congênitas com câmara ventricular única. Rev. Bras. Gir. Gardiovasc., 9 (2): 95-103, 1994. RESUMO: No período de março de 1990 a janeiro de 1994, 17 pacientes com idades de 1 a 13 anos (média: 7 anos), portadores de cardiopatias congênitas com câmara ventricular única funcionante, foram submetidos a operação de derivação cavo-pulmonar bidirecional. Nove pacientes tinham atresia tricúspide (AT) , 7 do tipo Ib , 1 tipo Ic e 1 tipo Ilb. Cinco pacientes tinham dupla via de entrada ventricular tipo ventrículo direito (DVEVD); 2 com comunicação interventricular (CIV) múltipla+hipoplasia do VD; 1 com atresia pu lmonarcom septo interventricular íntegro (APc/SIVI). Nove (52,9%) pacientes tinham operações paliativas prévias . A operação foi realizada com auxílio da circulação extracorpórea (CEC) em 12 (70 ,5%) casos e mediantederivação do fluxo sangüíneo da veia cava superior (VCS) para o átrio direito (AD) em 5 (29,5%) casos . Em todos os casos a VCS foi anastomosada à artéria pulmonar direita (APD), interrompendo o fluxo sangüíneo para o pulmão, fechando a valva pulmonar e ligando a derivação de Blalock-Taussig pérvio. Houve 3 (17 ,6%) óbitos no pós-operatório imediato (POI) e 2 (14,2%) no pós-operatório tardio (POT). Doze (70 ,5%) pacientes estão em acompanhamento clínico, com um tempo de evolução de 2 a 46 meses. Um paciente foi submetido ao 2º tempo da operação, tunelizando a veia cava inferior (VCI) para a APD, com sucesso. A avaliação do fluxo da derivação cavo-pulmonar bidirecional está sendo realizada pela ecodopplercardiografia e ressonância nuclear magnética e a perfusão pulmonar mediante cintilografia radioisotópica. A indicação do 2 2 tempo da operação obedece à própria evolução clínica e avaliação da saturação arterial durante a cicloergometria. A derivação cavo-pulmonar bidirecional permite uma adaptação progressiva do fluxo venoso para o pulmão, diminuindo a sobrecarga de volume do ventrículo, preparando o paciente para a derivação venosa total. DESCRITORES: derivação cavo-pulmonar, cirurgia INTRODUÇÃO A correção cirúrgica de cardiopatias congênitas que apresentam câmara ventricular única funcionante implica no emprego de técnicas paliativas, que orientam o fluxo venoso sistêmico para o pulmão, desativando o mecanismo pulsáti l do ventrículo pulmonar (hipoplásico e impróprio).

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Atriopulmonary anastomosis

Cited by 116 publications

References 15 publications

Comparison of the fenestrated and non-fenestrated Fontan procedures

Comparison of the fenestrated and non-fenestrated Fontan procedures

Interventional therapeutic procedures in cavopulmonary shunts

Avaliação dos resultados tardios da operação de derivação cavo-pulmonar bidirecional, no tratamento paliativo de cardiopatias congênitas com câmara ventricular única

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