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3, Приложение . 2021

Systemic veins in patients with functionally single ventricle: anatomic features and their influence to staged hemodynamic palliation

Abstract

Aim. To estimate the incidence of congenital and acquired malformations of systemic veins in patients with single-ventricle physiology and evaluate their impact on staged palliative repair. Material and methods. Retrospective cohort study based on data from 201 patients underwent surgical treatment from January 2005 till June 2021.

Results. We found congenital systemic vein anomalies in 19 (9%) patients. Most common anomalies were: bilateral superior caval veins, isolated hepatic vein drainage and interrupted inferior vena cava. Acquired venous pathology (veno-atrial fistulas) were found in 22 patients. Occlusion of the fistulas was performed either during the upcoming stage of repair (9 cases), or separately by transcatheter occlusion techniques (13 cases).

Conclusion. Single-ventricle patients may have congenital anomalies of number and localization of systemic veins that may have impact on timing of repair and technical aspects of the procedure. After partial and total cavo-pulmonary connection there is a risk of developing veno-atrial fistulas that may be occluded surgically of by transcatheter devises.

Keywords:congenital heart defects, single ventricle, heterotaxy syndrome, systemic veins anomalies, veno-atrial fistula

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Avramenko A.A., Svechkov N.A., Kislukhin T.V., Shorokhov S.E. Systemic veins in patients with functionally single ventricle: anatomic features and their influence to staged hemodynamic palliation. Clinical and Experimental Surgery. Petrovsky Journal. 2021; 9 (3). Supplement: 64-70. DOI: https://doi.org/10.33029/2308-1198-2021-9-3suppl-64-70 (in Russian)

References

1. Podzolkov V.P. Actual problems of surgical treatment of congenital heart defects with single-ventricle circulation by Fontan principle. Byulleten’ NTsSSKh imeni A.N. Bakuleva RAMN. Serdechno-sosudistye zabolevaniya [Bulletin of the Scientific Center of Cardiovascular Surgery named after A.N. Bakulev RAMS. Cardiovascular Diseases]. 2018; 19 (5): 625–36. (in Russian)

2. Kutty S., Frommelt M.A., Danford D.A., Tweddell J.S. Medium-term outcomes of Kawashima and completion Fontan palliation in single- ventricle heart disease with heterotaxy and interrupted inferior vena cava. Ann Thorac Surg. 2010; 90 (5): 1609–13.

3. Nath D.S., Carden A.J., Nussbaum D.P. Can the Kawashima procedure be performed in younger patients? Ann Thorac Surg. 2009; 88 (2): 581–6.

4. Vollebregt A., Pushparajah K., Rizvi M. Outcomes following the Kawashima procedure for single-ventricle palliation in left atrial isomerism. Eur J Cardiothorac Surg. 2012; 41 (3): 574–9.

5. Alsoufi B., Rosenblum J., Travers C., et al. Outcomes of Single Ventricle Patients Undergoing the Kawashima Procedure: Can We Do Better? World J Pediatr Congenit Heart Surg. 2019; 10 (1): 20–7.

6. Shuler J.M., Statile C., Heydarian H., et al. Surgical Timing and Outcomes of Unilateral Versus Bilateral Superior Cavopulmonary Anastomosis: An Analysis of Pediatric Heart Network Public Databases. Pediatr Cardiol. 2021; 42: 662–7.

7. Chen W., Lu Y., Ma L., Yang S., Xia Y., Zou M., et al. Conduit Route Selection for Total Cavopulmonary Connection in Patients with Apicocaval Juxtaposition. Semin Thorac Cardiovasc Surg. 2019; 31 (1): 104-9.

8.    Morizumi S., Kato H., Kanemoto S., Noma M., Abe M., Sakakibara Y., et al. Appropriate route selection for extracardiac total cavopulmonary connection in apicocaval juxtaposition. Ann Thorac Surg. 2012; 94: 179-84.

9.    Sakurai T., Kado H., Nakano T., Hinokiyama K., Oda S., Sugiura J., et al. The impact of extracardiac conduit-total cavopulmonary connection on apicoca-val juxtaposition. Eur J Cardiothorac Surg. 2010; 38: 439-44.

10.    Chen W., Lu Y., Ma L., Yang S., Xia Y., Zou M., et al. Conduit route selection for total cavopulmonary connection in patients with apicocaval juxtaposition. Semin Thorac Cardiovasc Surg. 2019; 31: 104-9.

11.    Sinha L., Ozturk M., Zurakowski D., Yerebakan C., Ramakrishnan K., Matisoff A., et al. Intra-extracardiac versus extracardiac Fontan modifications: comparison of early outcomes. Ann Thorac Surg. 2019; 107: 560-6.

12.    Heinemann M., Breuer J., Steger V., Steil E., Sieverding L., Ziemer G. Incidence and impact of systemic venous collateral development after Glenn and Fontan procedures. Thorac Cardiovasc Surg. 2001; 49: 172-8.

13.    Lluri G., Levi D.S., Aboulhosn J. Systemic to pulmonary venous collaterals in adults with single ventricle physiology after cavopulmonary palliation. Int J Cardiol. 2015; 189: 159-63.

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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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