PT  - JOURNAL ARTICLE
AU  - L H P M Filippini
AU  - C Ovaert
AU  - D G Nykanen
AU  - R M Freedom
TI  - Reopening of persistent left superior caval vein after bidirectional cavopulmonary connections
AID  - 10.1136/hrt.79.5.509
DP  - 1998 May 01
TA  - Heart
PG  - 509--512
VI  - 79
IP  - 5
4099  - http://heart.bmj.com/content/79/5/509.short
4100  - http://heart.bmj.com/content/79/5/509.full
SO  - Heart1998 May 01; 79
AB  - Persistent left superior vena cava (SVC) is a not uncommon finding in patients with congenital heart disease. This anatomical variant must be recognised before doing a Glenn anastomosis, bidirectional cavopulmonary connection or a Fontan-type procedure. Following these procedures, reopening of a left SVC leading to clinical cyanosis can occur. Five cases are described in whom persisting left SVCs were excluded before performing a bidirectional cavopulmonary connection or Fontan procedure but (re-)opened after surgery, leading to cyanosis either by reducing effective pulmonary blood flow (bidirectional cavopulmonary connection) or by an obligatory right to left shunt (Fontan). These observations suggest that, embryologically, the lumen of the left SVC obliterates rather than disappears. Balloon occlusion angiography of the innominate vein before cavopulmonary connections or Fontan procedures might improve detection of these collateral vessels.