Percutaneous Closure of a Large Unligated Vertical Vein Using the Amplatzer Vascular Plug II After Supracardiac Total Anomalous Pulmonary Venous Connection (TAPVC) Repair

Abstract

It is well known that the vertical vein (VV) may have to be left open after repair of a total anomalous pulmonary venous connection (TAPVC) in children with preoperative obstruction, whose left heart chambers are small (Cope et al. in Ann Thorac Surg 64:23-29, 3). An unligated VV has been found to reduce pulmonary arterial pressure, decrease perioperative pulmonary hypertensive crisis, and provide better hemodynamics postoperatively (Chowdhry et al. in J Thorac Cardiovasc Surg 133:1286-1294, 2). Although these VVs are expected to close later, they may remain patent in about half of these children (Cheung et al. J Paediatr Child Health 41:361-364, 1).The patent VVs may be a cause for significant left-to-right shunting, and the children may be symptomatic. The case report describes a child who had a large patent VV after repair of supracardiac TAPVC and its closure using the Amplatzer Vascular Plug II device.