Modified fenestration technique for the Kawashima operation in a young infant

Picarelli, Dante; Montenegro, José Luis; Antúnez, Serrana; Pérez, Walter; Borbonet, Daniel

doi:10.1016/j.jtcvs.2004.06.018

Cited by 8 publications

(8 citation statements)

References 4 publications

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“…Dr G Kreutzer and colleagues from Argentina published their innovative work in the early 1970s and, along with Dr Fontan, set the technical surgical foundations for the operation subsequently known world wide as the Fontan–Kreutzer procedure 75. After Dr Kreutzer’s initial description, several modifications have been proposed and employed in South America, with evolving results 76777879808182838485. Creation of a fenestration is still debatable 82.…”

Section: Outcomes After Medical Surgical or Interventional Treatmentmentioning

confidence: 99%

“…Creation of a fenestration is still debatable 82. The Fontan–Kreutzer procedure is still a challenging operation and continues to stimulate surgeons and clinicians to broaden their clinical research in the field 82838485. There have been some interesting observations from centres in South America about ventricular remodelling in patients with tricuspid atresia before surgery86 and endothelial dysfunction before and after the Fontan–Kreutzer operation 8788…”

Section: Outcomes After Medical Surgical or Interventional Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Paediatric and congenital heart disease in South America: an overview

Pedra

Haddad²,

Pedra³

et al. 2009

Heart

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Congenital heart diseases are one of the most common structural defects present at birth, with an approximate incidence of 8 per 1000 live births. As most countries in South America have a high birth rate, they are a significant public health concern. This paper provides a brief overview of the burden of congenital heart disease in South America, focusing on its local prevalence, facilities for treatment and outcomes after medical, surgical or catheter intervention for the most common diseases.

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Section: Outcomes After Medical Surgical or Interventional Treatmentmentioning

confidence: 99%

Section: Outcomes After Medical Surgical or Interventional Treatmentmentioning

confidence: 99%

Paediatric and congenital heart disease in South America: an overview

Pedra

Haddad²,

Pedra³

et al. 2009

Heart

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show abstract

“…In our view, patients with azygos continuation of the IVC to the SVC who have undergone a prior Norwood procedure should be considered for fenestration, particularly if PA development is suboptimal. There are a few case reports of Kawashima procedures 6 –9 with various methods described for creating a fenestration. These cases did not report patients having prior Norwood operations.…”

Section: Discussionmentioning

confidence: 99%

Kawashima by Fenestrated Hemi-Fontan for Palliation Following Prior Stage I Norwood Operation

Zablah

Ross

Wilson

et al. 2018

World J Pediatr Congenit Heart Surg

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Single ventricle patients with interrupted inferior vena cava (IVC) and azygos continuation to the superior vena cava (SVC) are typically palliated with a bidirectional cavopulmonary shunt (BCPS), known as the Kawashima operation in this setting. Because the volume of venous blood directed to the pulmonary arteries is substantially greater in the presence of interrupted IVC, Kawashima procedures are commonly delayed to older age compared to other single ventricle patients undergoing BCPS. We report two young infant single ventricle patients with interrupted IVC and azygos continuation to the SVC who underwent stage I Norwood procedures for initial palliation. In both cases, a fenestrated hemi-Fontan procedure achieved successful Kawashima circulations.

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“…Some patients undergoing the KO may benefit from a fenestration, which has been done in a variety of ways, including connection of the right or the left atrial appendages to the ipsilateral pulmonary artery branch or the SVC. 4,5 With the approach reported here, a fenestration can easily be performed by making a small 3 to 4 mm orifice in the pericardial patch that divides the ePTFE conduit. As reported by Zablah and collaborators in a fenestrated hemi-Fontan procedure, this provides an easy way of decompressing the pulmonary system and facilitates transcatheter Fontan-Kreutzer completion.…”

Section: Commentmentioning

confidence: 99%

The Kawashima Operation With Simultaneous Preparation for Transcatheter Fontan-Kreutzer Completion

Lugones

Junco

Biancolini

et al. 2019

World J Pediatr Congenit Heart Surg

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Patients with functionally single ventricle and interrupted inferior vena cava may develop progressive cyanosis soon after the Kawashima operation. Therefore, early redirection of the hepatic venous return to the pulmonary circulation is recommended. To avoid performing an early redo sternotomy, we propose to prepare these patients for the interventional Fontan-Kreutzer at the time of the Kawashima operation using a technical modification of the approach reported by Prabhu and coworkers in 2017. The technique described here uses an expanded polytetrafluoroethylene conduit interposed between the hepatic veins and the right pulmonary artery. This graft is everted and divided into two portions with a pericardial patch. The lower one is widely opened and anastomosed side-to-side to the atrium. A few months after the operation, percutaneous Fontan-Kreutzer completion can easily be performed using covered stents to open the patch and at the same time close the opening between the conduit and the atrium.

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Modified fenestration technique for the Kawashima operation in a young infant

Cited by 8 publications

References 4 publications

Paediatric and congenital heart disease in South America: an overview

Paediatric and congenital heart disease in South America: an overview

Kawashima by Fenestrated Hemi-Fontan for Palliation Following Prior Stage I Norwood Operation

The Kawashima Operation With Simultaneous Preparation for Transcatheter Fontan-Kreutzer Completion

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