{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T19:00:55Z","timestamp":1784660455990,"version":"3.55.0"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The Kawashima procedure is a variant of the bidirectional Glenn used in patients with interrupted inferior vena cava (IVC) and azygos continuation, though optimal timing and the role of fenestration remain debated. We report a 5-month-old boy with functional single ventricle physiology, transposition of the great arteries, pulmonary valve atresia with ventricular septal defect, interrupted IVC with azygos continuation, and bilateral superior vena cavae, who presented with cyanosis and failure to thrive. Imaging confirmed complex venous anomalies with hepatic venous drainage directly into the right atrium. The patient underwent a Kawashima procedure without fenestration, with stable postoperative hemodynamics, improved oxygen saturation, and an uncomplicated recovery. This case demonstrates that early Kawashima without fenestration is feasible in carefully selected infants, although exclusion of hepatic venous flow may predispose to pulmonary arteriovenous malformations, necessitating eventual Fontan completion. Favorable outcomes can be achieved in resource-limited settings with appropriate patient selection and multidisciplinary care.<\/jats:p>","DOI":"10.1093\/jscr\/rjag563","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:53:59Z","timestamp":1783684439000},"source":"Crossref","is-referenced-by-count":0,"title":["Kawashima procedure without fenestration in a 5-month-old infant with functional single ventricle and interrupted inferior vena cava: a case report"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9757-7894","authenticated-orcid":false,"given":"Khanh Van T","family":"Le","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiac Surgery, Cho Ray Hospital , 201B Nguyen Chi Thanh Street, Cho Lon Ward, Ho Chi Minh City 700000 ,","place":["Vietnam"]},{"name":"Department of Medicine, School of Medicine and Pharmacy, Tra Vinh University , 126 Nguyen Thien Thanh Street, Ward 5, Tra Vinh City 940000 ,","place":["Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2748-8336","authenticated-orcid":false,"given":"Tin D","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Cho Ray Hospital , 201B Nguyen Chi Thanh Street, Cho Lon Ward, Ho Chi Minh City 700000 ,","place":["Vietnam"]},{"name":"Department of Thoracic and Vascular Surgery, College of Health Sciences, Nam Can Tho University , 168 Nguyen Van Cu Ext Street, An Binh Ward, Ninh Kieu District, Can Tho City 94118 ,","place":["Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"2026072114005138100_ref1","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1148\/radiographics.20.3.g00ma09639","article-title":"Spectrum of congenital anomalies of the inferior vena cava: cross-sectional imaging findings","volume":"20","author":"Bass","year":"2000","journal-title":"Radiographics"},{"key":"2026072114005138100_ref2","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1016\/S0894-7317(98)70160-9","article-title":"Infrahepatic interruption of the inferior vena cava with azygos continuation: a potential mimicker of aortic pathology","volume":"11","author":"Blanchard","year":"1998","journal-title":"J Am Soc Echocardiogr"},{"key":"2026072114005138100_ref3","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1016\/j.athoracsur.2010.06.114","article-title":"Medium-term outcomes of Kawashima and completion Fontan palliation in single-ventricle heart disease with heterotaxy and interrupted inferior vena cava","volume":"90","author":"Kutty","year":"2010","journal-title":"Ann Thorac Surg"},{"key":"2026072114005138100_ref4","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1093\/ejcts\/ezr003","article-title":"Outcomes following the Kawashima procedure for single-ventricle palliation in left atrial isomerism","volume":"41","author":"Vollebregt","year":"2012","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026072114005138100_ref5","first-page":"1011","article-title":"Should we always plan a Fontan completion after a Kawashima procedure?","volume":"40","author":"Setyapranata","year":"2011","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026072114005138100_ref6","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.athoracsur.2022.10.015","article-title":"Kawashima procedure: the impact of age","volume":"116","author":"Ivanov","year":"2023","journal-title":"Ann Thorac Surg"},{"key":"2026072114005138100_ref7","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.athoracsur.2023.07.012","article-title":"Outcomes of the Kawashima: a Society of Thoracic Surgeons Congenital Heart Surgery Database Analysis","volume":"117","author":"Miller","year":"2024","journal-title":"Ann Thorac Surg"},{"key":"2026072114005138100_ref8","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.athoracsur.2009.04.045","article-title":"Can the Kawashima procedure be performed in younger patients?","volume":"88","author":"Nath","year":"2009","journal-title":"Ann Thorac Surg"},{"key":"2026072114005138100_ref9","doi-asserted-by":"crossref","first-page":"ezaf058","DOI":"10.1093\/ejcts\/ezaf058","article-title":"Clinical outcomes of Kawashima procedure and subsequent hepatic vein incorporation","volume":"67","author":"Behrend","year":"2025","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026072114005138100_ref10","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/S0003-4975(02)04281-9","article-title":"The fenestrated Kawashima operation for single ventricle with interrupted inferior vena cava","volume":"75","author":"Hannan","year":"2003","journal-title":"Ann Thorac Surg"},{"key":"2026072114005138100_ref11","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1093\/ejcts\/ezr280","article-title":"Current outcomes of the Glenn bidirectional cavopulmonary connection for single ventricle palliation","volume":"42","author":"Alsoufi","year":"2012","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026072114005138100_ref12","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.jacc.2011.09.022","article-title":"Hypoplastic left heart syndrome: current considerations and expectations","volume":"59","author":"Feinstein","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"2026072114005138100_ref13","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1016\/j.athoracsur.2005.04.043","article-title":"Pulmonary arteriovenous malformations in children after the Kawashima operation","volume":"80","author":"Brown","year":"2005","journal-title":"Ann Thorac Surg"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/7\/rjag563\/69711006\/rjag563.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/7\/rjag563\/69711006\/rjag563.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T18:00:59Z","timestamp":1784656859000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjag563\/8739331"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":13,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7,4]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjag563","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,7]]},"article-number":"rjag563"}}