Abstract
A residual hepatic vein to left atrial communication may result in progressive cyanosis after the Fontan procedure. This problem has usually been treated surgically by ligation or re-inclusion of the residual hepatic vein in the Fontan circulation. Previous attempts at transcatheter closure of such veins have been unsuccessful. An Amplatzer septal occluder was successfully used for transcatheter closure of a post-Fontan hepatic vein to pulmonary venous atrium fistula in an 8 year old boy. Keywords: hepatic vein; Fontan procedure; Amplatzer septal occluder; congenital heart disease
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Figure 1 .
Angiogram of the inferior vena cava showing multiple venous collaterals in the liver draining into the residual left sided hepatic vein to pulmonary venous atrium fistula. The exit into the pulmonary venous atrium was 10 mm wide.
Figure 2 .
(A) A front loaded 10 mm Amplatzer septal occluder deployed at the exit of the fistula via a 7 F long sheath passed through a 10 F armoured long sheath. (B) The Amplatzer septal occluder has been released. An angiogram via the long sheath shows complete occlusion of the exit of the residual hepatic vein to pulmonary venous atrium fistula.