The Kawashima procedure is used for congenital heart disease with a single effective ventricle and an interrupted inferior vena cava (IVC). It was first performed in and reported in Redmond Burke MD, Chief of Pediatric Cardiovascular Surgery at demonstrates the operative technique for the Kawashima Procedure at. She had an uneventful postoperative course. The Kawashima operation is an established surgical procedure to deal with bilateral SVCs. The procedure is safe; outcome is favourable and prepares the patient for total cavo-pulmonary shunt.


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A seven years old girl kawashima operation admitted via emergency with severe cyanosis. She had tricuspid atresia, azygos continuation of IVC with single ventricle physiology. She had a complicated postoperative course with prolonged hospital stay after bilateral bidirectional Glen shunt Kawashima operation.

In two of these patients, hepatic flow was demonstrated to be draining only to one side of the lung and the ipsilateral vascular malformations had regressed, while the malformations in the kawashima operation lung persisted Fig.

These two patients underwent Fontan revision to ensure that the hepatic flow reached both lungs at 2.

The last patient diagnosed to have persistent malformations 4 months after Fontan was lost to follow-up. In an additional patient, collaterals between hepatic veins and the left atrium kawashima operation embolised.

Kawashima procedure

Catheterisation was deemed to be not necessary in the remaining seven patients as their oxygen saturations had improved. Two years after Fontan completion, no evidence of arteriovenous malformations in the right lung Kawashima operation and persistence of malformations in the left lung D.

E Blood of the hemiazygous vein distributed to both lungs. F Blood from the hepatic veins distributed exclusively to the right lung. At last follow-up, a median of 7.

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Among the seven patients who did not develop pulmonary arteriovenous malformations after the Kawashima Fig. Indication for Fontan completion was decreased exercise tolerance in all four patients and associated with severe atrioventricular valve regurgitation, with no evidence kawashima operation arteriovenous kawashima operation on catheterisation in one.

Two patients had collaterals to hepatic veins, contributing to systemic desaturation. These collaterals were embolised during interventional catheterisation preoperatively.

Kawashima procedure - Wikipedia

At last follow-up after As a result, there is much less hypoxia than after Glenn, and the kawashima operation is pumping less additional blood than after Glenn.

Hepatoazygos venous shunt for Fontan completion after Kawashima operation.


Ann Pediatr Card ;9: With better understanding of Fontan physiology and its associated kawashima operation, the procedure itself has undergone continuous evolutions since its inception. In those patients with the interruption of inferior vena cava IVC and azygos or hemiazygos continuation, The Kawashima operation is a bidirectional superior cavopulmonary shunt performed for first stage palliation of single ventricle patients with interruption of inferior vena cava IVC.

Here, except for the portal venous return, all systemic venous return is made to enter the pulmonary arteries, bypassing the heart. Various methods for the surgical completion of routing hepatic veins HVs to the pulmonary arteries by means of intracardiac or extracardiac conduits have been described.

Case Report We report a case of an 8-year, 5-month-old boy who was diagnosed at the age kawashima operation 18 months with complex congenital heart disease with left atrial isomerism.

He had an unbalanced atrioventricular kawashima operation defect with a single ventricle right ventricle physiology, double outlet right ventricle with main pulmonary and right pulmonary artery RPA stenosis, and interrupted IVC with hemiazygos continuation with a single left superior vena cava LSVC.

The kawashima operation underwent a Kawashima operation with RPA plasty at the age of 2 years, following which his oxygen saturation improved.