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Device Occlusion of Native Pulmonary Blood Flow After Cavopulmonary Anastomosis With Persistent Pleural Effusions

Sophia Khan1, Abdulla Tarmahomed1, Salim Jivanji1,2

  • 1Alder Hey Children's Hospital, Liverpool, United Kingdom.

JACC. Case Reports
|August 8, 2022
PubMed

Insights

Native pulmonary flow after cavopulmonary anastomosis can cause issues. A ventricular septal defect occluder device was used to manage prolonged pleural effusions in a young child post-surgery.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Thoracic Surgery

Background:

  • Cavopulmonary anastomosis is a surgical procedure to treat complex congenital heart defects.
  • Native pulmonary blood flow can influence pulmonary artery development but may lead to complications.
  • Prolonged pleural effusions are a known, albeit undesirable, consequence post-cavopulmonary anastomosis.

Observation:

  • A 17-month-old child experienced persistent pleural effusions following a cavopulmonary anastomosis.
  • The child had a ventricular septal defect, which was managed during the surgical course.
  • An occluder device, typically used for ventricular septal defects, was placed in the native right ventricular outflow tract.

Findings:

  • The placement of a ventricular septal defect occluder device in the native right ventricular outflow tract was a novel approach.
  • This intervention was performed in the context of managing prolonged pleural effusions post-cavopulmonary anastomosis.
  • The case highlights an advanced application of device closure in a complex pediatric cardiac surgical scenario.

Implications:

  • This case suggests a potential, albeit unconventional, therapeutic option for managing specific complications after cavopulmonary anastomosis.
  • Further investigation is warranted to understand the efficacy and safety of using VSD occluders in the native RVOT for pleural effusion management.
  • This approach may offer insights into alternative strategies for optimizing outcomes in complex pediatric cardiac surgery.

Keywords:
APBF, antegrade pulmonary blood flowCavopulmonaryVSD, ventricular septal defectpediatricpleural effusionsright pulmonary outflow tractventricular septal defect occluder

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