Choice of venous access for cardiac catheterization in patients with congenital heart disease

Transhepatic closure of a post-fontan hepatic veins to left atrium fenestration in visceral heterotaxia and dextrocardia

This article reports on the transhepatic closure of post-Fontan hepatic veins to left atrium fenestration in a 13-year-old girl with left atrial isomerism, dextrocardia, azygos continuation to the left superior vena cava, and median liver. The transhepatic route seemed to be the less tortuous access to the fenestration which was previously partially occluded with a CardioSeal device. The hepatic veins were entered at the left abdominal side using fluoroscopic guidance and the fenestration was uneventfully occluded with an Amplatzer septal occluder device.