Resolution of pulmonary arteriovenous fistula by redirection of hepatic venous blood

Transcatheter redirection of hepatic venous blood to treat unilateral pulmonary arteriovenous malformations in a Fontan circulation by short‐term total exclusion of the unaffected lung

“…Pulmonary arteriovenous malformations (PAVM) are a recognized complication of a bidirectional Glenn or Fontan circulation due to uneven distribution of hepatic venous (HV) effluent to the lungs, particularly in patients with polysplenia syndrome and an interrupted inferior vena cava with azygous continuation . There are reported surgical techniques to reroute HV blood flow to the affected lung with short‐term follow‐up demonstrating fewer PAVMs and higher oxygen saturation . Given the comorbidities and surgical risk of the adult Fontan population, transcatheter approaches to redirect HV blood flow are desirable, and recently transcatheter techniques have been reported .…”

“…[1][2][3] There are reported surgical techniques to reroute HV blood flow to the affected lung with short-term follow-up demonstrating fewer PAVMs and higher oxygen saturation. [4][5][6][7][8][9][10][11] Given the comorbidities and surgical risk of the adult Fontan population, transcatheter approaches to redirect HV blood flow are desirable, and recently transcatheter techniques have been reported. [11][12][13] We report a case of a novel multistage transcatheter approach to treat single-sided PAVMs by initially excluding the unaffected lung from the HV conduit.…”

Pulmonary arteriovenous malformations after a Fontan operation in the left isomerism and absent inferior vena cava☆

“…PAVM might develop after the establishment of the Fontan circulation due to the unbalanced pulmonary perfusion of HV blood flow [1]. A few studies have found that revision of the Fontan pathway after a Fontan operation by redirection of HV blood flow causes PAVM resolution in patients with LI and absent IVC [12][13][14].…”

Normal and abnormal pulmonary arteriovenous shunting: occurrence and mechanisms

“…Furthermore, in cavopulmonary anastomoses, the hepatic venous drainage reaches the lungs only after passing through the systemic circulation, and re-routing hepatic venous drainage to the pulmonary arteries may cause the venous admixture to decrease and even disappear. 44,52,82,[90][91][92][93][94][95][96][97][98][99] Similar changes have been seen after correction of isolated inferior caval vein or hepatic venous drainage into the left atrium. 53,54,100 Dilution or loss of substance?…”