trans catheter device closure of a large azygos vein in adult patient with systemic venous collateral development after the bidirectional glenn shunt

Superior cavopulmonary anastomosis is a type of palliative cardiac surgeries that usually done in children with cyanotic and complex congenital heart disease who have single ventricle profile. bdg shunt is staged palliation procedure for single ventricle patients who are candidates for total cavopulmonary connection (tcpc). sometimes the surgeon misses ligating or intentionally leaves the azygos vein as a fenestration or emergency exit. this allows an abnormal flow from the superior vena cava (svc into azygos vein). these patients can present progressive desaturation, chest tightness, progressive dyspnea, edema and shortness of breath. therapeutic options include observation, surgical ligation and trans catheter closure. because of high risks and extra traumas of surgery and greater chance for difficulties and the feasibility of trans catheter therapy, it is done in some centers as a method of choice.