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Incidence and impact of systemic venous collateral development after Glenn and Fontan procedures

M Heinemann1, J Breuer, V Steger

  • 1Abteilung für Thorax-, Herz- und Gefässchirurgie, Universitätsklinik Tübingen, Germany. heinemann@uni-mainz.de

The Thoracic and Cardiovascular Surgeon
|July 4, 2001
PubMed

Insights

Systemic venous collaterals can develop after Glenn or Fontan procedures, impacting heart function. Early identification and intervention for these venous connections are crucial for patient outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Vascular Biology

Background:

  • Univentricular heart disease poses challenges post-Glenn or Fontan procedures.
  • Systemic venous collateral development can impair ventricular function and cause desaturation.

Observation:

  • Seventy-nine patients undergoing Glenn or Fontan procedures were analyzed.
  • Systemic venous collaterals were detected in 20.2% of patients postoperatively.
  • Common sites included brachiocephalic/pericardial veins and the azygos/hemiazygos system.

Findings:

  • Nineteen veno-venous connections were identified.
  • Drainage pathways varied, including pulmonary veins and the left atrium.
  • Five patients required intervention (catheter embolization or surgical closure) for low saturations, all with improved outcomes.

Implications:

  • Increased central venous pressure post-Fontan/Glenn may reactivate embryonic vessels.
  • Pre- and postoperative evaluation of collateral sites is essential.
  • Ligation during surgery and interventional/surgical closure are vital management strategies.
Abstract

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