First-in-man transcatheter Fontan completion in post Kawashima patient after successful recruiting of separately draining hepatic veins - A case report.

Background: Heterotaxy patients after Kawashima surgery, with separately draining hepatic veins pose a complexity for Fontan completion. We describe a novel percutaneous technique for hepatic vein diversion and complete transcatheter Fontan.

Case report: A 6-year-old female with single ventricle physiology and bilateral hepatic vein drainage underwent Kawashima surgery. She later developed a complete heart block and elevated mean pulmonary pressures (17 mmHg). Permanent pacemaker implantation and left hepatic vein ligation were performed. Due to elevated pulmonary pressures, transcatheter Fontan completion was chosen over surgical options, and hepatic veins were included without prior surgical preparation as there were well-developed venous collaterals between the hepatic veins. The patient remained asymptomatic post-intervention with no complications and was discharged on anticoagulation therapy.