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Submitted: 20 Sep 2020
Revision: 07 Feb 2021
Accepted: 12 Feb 2021
ePublished: 14 Apr 2021
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J Cardiovasc Thorac Res. 2021;13(4): 364-366.
doi: 10.34172/jcvtr.2021.22

Scopus ID: 85123539486
  Abstract View: 525
  PDF Download: 317
  Full Text View: 79

Case Report

Non diagnosed PAPVC induce large reverse venovenous shunt after modified Fontan surgery: A case report of a rare anomaly and embolization therapy

Zahra Alizadeh Sani 1, Abdolrahim Ghasemi 2, Shabnam Mohammadzadeh 3, Zahra Khajali 4, Mohaddeseh Behjati 4, Roohallah Alizadehsani 5*, Abbas Khosravi 5, Saeid Nahavandi 5, Sheikh Mohammed Shariful Islam 6,7,8

1 MRI Department, Shaheed Rajaei Cardiovascular & Medical Research Center, Iran University of Medical Sciences, Tehran, Iran
2 Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
4 Shaheed Rajaei Cardiovascular & Medical Research Center, Iran University of Medical Sciences, Tehran, Iran
5 Institute for Intelligent Systems Research and Innovation, Deakin University, Geelong, VIC 3216, Australia
6 Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
7 Cardiovascular Division, The George Institute for Global Health, Australia
8 Sydney Medical School, University of Sydney, Australia
*Corresponding Author: *Corresponding Author: Roohallah Alizadehsani, Email: , Email: ralizadehsani@deakin.edu.au

Abstract

Fontan operation is a reliable palliative surgery for patients with single ventricle physiology. Still, the development of complication is common; one of these complications that need to interventional approach is veno-venous collaterals between systemic and pulmonary veins. A 16-yearoldgirl with a history of modified Fontan operation at 9 years ago was referred with progressive cyanosis and dyspnea on exertion. In contrast trans-thoracic echocardiography (TTE), no fenestration was seen in Fontan circulation. Cardiac magnetic resonance revealed partial anomalous pulmonary vein connection (PAPVC) from left upper pulmonary vein to vertical vein and then into the in nominate vein and SVC with the reverse flow from superior vena cava (SVC) to left upper pulmonary vein(LUPV). This anomalous vein became severe engorged and tortuous. Possibly, LUPV and the verticalvein was dilated gradually as a result of increased pressure in the Fontan circuit. Finally, she underwent successful coil embolization in the midpart of the vertical vein. The oxygen saturation increased from80% to 93%.


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