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Open Access Case report

Progressive cyanosis following Kawashima operation: slow resolution after redirection of hepatic veins

Signe Holm Larsen13*, Kristian Emmertsen1, Jesper Bjerre2 and Vibeke Elisabeth Hjortdal3

Author Affiliations

1 Department of Cardiology, Aarhus University Hospital, Brendstrupgaardsvej, 8200 Aarhus N, Denmark

2 Department of Pediatrics, Aarhus University Hospital, Brendstrupgaardsvej, 8200 Aarhus N, Denmark

3 Department of Cardiothoracic surgery, Aarhus University Hospital, Brendstrupgaardsvej, 8200 Aarhus N, Denmark

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Journal of Cardiothoracic Surgery 2013, 8:67  doi:10.1186/1749-8090-8-67

Published: 5 April 2013

Abstract

Progressive cyanosis often develops following Kawashima operation in patients with left atrial isomerism, interrupted inferior vena cava and hepatic veins draining to the atria. Knowledge on the timing and extend of resolution following hepatic venous redirection is sparse. A girl developed progressing cyanosis following Kawashima operation at the age of ten months. Arterial oxygen saturations at rest dropped to 60-65%. Surgical redirection of hepatic veins into the cavopulmonary circulation at the age of three years had no immediate effect. However, arterial oxygen saturations increased gradually over nine months to 90-93% and 95-100% after three years.

Keywords:
Congenital heart surgery; Pulmonary arteriovenous malformations; Fontan; Left atrial isomerism