Anomalous hepatic vein drainage to the atrium following extracardiac total cavopulmonary connection: a case report and literature review

The discovery of anomalous hepatic vein drainage into the atrium following extracardiac total cavopulmonary connection in patients with single ventricle is extremely rare. This study aims to enhance our understanding of this phenomenon. We report a case of a congenital heart disease patient who underwent extracardiac total cavopulmonary connection. Postoperatively, the patient experienced progressive low oxygen saturation and cyanosis. Cardiac catheterization and contrast CT revealed hepatic vein drainage into the atrium. Surgical ligation of the hepatic vein was performed, resulting in normalization of oxygen saturation and significant improvement of cyanosis. The patient has been in good condition during follow-up. For patients experiencing progressive cyanosis and hypoxemia after extracardiac total cavopulmonary connection, the possibility of anomalous hepatic vein drainage should be considered, although rare. This can be confirmed through cardiac catheterization or contrast enhanced CT. Ligation of the anomalous hepatic vein can significantly improve the condition.