Kawashima procedure

Kawashima procedure
Specialty	Cardiology
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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 1978 and reported in 1984.^[1]

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Transcription

Procedure

Technically it is very similar to the bidirectional Glenn procedure used to direct half the body's venous blood flow into the lungs. However, in patients with interrupted IVC, most of the blood from the lower body actually joins the blood from the upper body before returning to the heart via the superior vena cava (SVC). Therefore, the redirection of SVC blood to the lungs (as in the Glenn) results in much more than half the venous blood flow being diverted.^{[citation needed]}

After Kawashima, the only de-oxygenated blood returning to the heart is from the abdominal organs (via the hepatic veins). As a result, there is much less hypoxia than after Glenn, and the heart is pumping less additional blood than after Glenn. However, the hypoxia can worsen over time (because of the development of microscopic AVMs in the lungs that allow blood to pass through without being oxygenated),^[2] and therefore these children still may need a complete Fontan procedure in the end.^[3]^[4]

References

^ Kawashima Y, Kitamura S, Matsuda H, Shimazaki Y, Nakano S, Hirose H (1984). "Total cavopulmonary shunt operation in complex cardiac anomalies. A new operation". J. Thorac. Cardiovasc. Surg. 87 (1): 74–81. PMID 6690861.
^ Kawashima Y (1997). "Cavopulmonary shunt and pulmonary arteriovenous malformations". Ann. Thorac. Surg. 63 (4): 930–2. doi:10.1016/S0003-4975(97)00055-6. PMID 9124964.
^ McElhinney DB, Kreutzer J, Lang P, Mayer JE, del Nido PJ, Lock JE (2005). "Incorporation of the hepatic veins into the cavopulmonary circulation in patients with heterotaxy and pulmonary arteriovenous malformations after a Kawashima procedure". Ann. Thorac. Surg. 80 (5): 1597–603. doi:10.1016/j.athoracsur.2005.05.101. PMID 16242423.
^ Brown JW, Ruzmetov M, Vijay P, Rodefeld MD, Turrentine MW (2005). "Pulmonary arteriovenous malformations in children after the Kawashima operation". Ann. Thorac. Surg. 80 (5): 1592–6. doi:10.1016/j.athoracsur.2005.04.043. PMID 16242422.

Tests and procedures involving the heart

Surgery

Heart valves and septa	Valve repair Valvulotomy Mitral valve repair Valvuloplasty aortic mitral Valve replacement Aortic valve repair Aortic valve replacement Ross procedure Percutaneous aortic valve replacement Mitral valve replacement Percutaneous pulmonary valve implantation production of septal defect in heart enlargement of existing septal defect Atrial septostomy Balloon septostomy creation of septal defect in heart Blalock–Hanlon procedure shunt from heart chamber to blood vessel atrium to pulmonary artery Fontan procedure left ventricle to aorta Rastelli procedure right ventricle to pulmonary artery Sano shunt compound procedures for transposition of the great vessels Arterial switch operation Mustard procedure Senning procedure for univentricular defect Norwood procedure Kawashima procedure shunt from blood vessel to blood vessel systemic circulation to pulmonary artery shunt Blalock–Taussig shunt SVC to the right PA Glenn procedure
Cardiac vessels	CHD Angioplasty Bypass/Coronary artery bypass MIDCAB Off-pump CAB TECAB Coronary stent Bare-metal stent Drug-eluting stent Bentall procedure Valve-sparing aortic root replacement LeCompte maneuver
Other	Pericardium Pericardiocentesis Pericardial window Pericardiectomy Myocardium Cardiomyoplasty Dor procedure Septal myectomy Ventricular reduction Alcohol septal ablation Conduction system Maze procedure (Cox maze and minimaze) Catheter ablation Cryoablation Radiofrequency ablation Pacemaker insertion S-ICD implantation ICD implantation Cardiac resynchronization therapy Left atrial appendage occlusion Cardiotomy Heart transplantation