Management of azygos vein "steal" following hemi-Fontan by transcatheter coil embolization

Hemiazygos vein "steal hypoxic-syndrome" after hemi-Fontan operation: comprehensive four-dimensional flow magnetic resonance visualisation

A 2-year-old boy with hypoplastic left heart syndrome and previous hemi-Fontan palliation surgery was referred for cardiovascular magnetic resonance evaluation because of progressive cyanosis. This case report illustrates the advantages of non-invasive four-dimensional magnetic resonance imaging for comprehensive identification and quantification of venovenous collaterals in patients with palliated hemi-Fontan staged surgery.

Techniques and applications of transcatheter embolization procedures in pediatric cardiology

Transcatheter embolization of congenital or acquired superfluous vascular structure has become routine procedures performed by interventional pediatric cardiologists. Embolization procedure is often part of a collaborative effort with cardiac surgeons to palliate complex congenital heart defect, such as in embolizing aortopulmonary collateral arteries in patient with single ventricle physiology. In other cases, the procedure is the definitive treatment as in embolizing coronary artery fistula. Pediatric cardiologists performing embolization procedures should be familiar with available technologies as well as understand the underlying cardiac anatomy and pathophysiology. This article provides a comprehensive review of presently available embolization agents and technologies. Some of the technologies are used only by interventional radiologists but may be useful to pediatric cardiologists. Specific clinical applications in pediatric cardiology are also discussed with summary of current literature. With continue advancement in transcatheter technology and operator expertise, all unwanted vascular communication should be amenable to transcatheter embolization.