{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:00:58Z","timestamp":1790949658390,"version":"4.1.0"},"reference-count":11,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["World J Pediatr Congenit Heart Surg"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulmonary arteriovenous malformations (PAVMs) are a major cause of cyanosis after bidirectional cavopulmonary connection. We evaluated the effects of axillary arteriovenous fistula (AAVF) creation in managing PAVMs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study included patients who underwent AAVF creation from 2014 to 2022 with \u22656 months of follow-up. Patients underwent diagnostic cardiac catheterization to assess hemodynamic and angiographic response to AAVF. Oxygen saturation (SO\n                      <jats:sub>2<\/jats:sub>\n                      ) was recorded at 1, 2, and 6 months postoperatively, then every 3-6 months, and temporal correlations were analyzed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twelve patients underwent AAVF creation. Nine (75%) showed improvement; 5 proceeded to total cavopulmonary connection (Fontan), and 4 remained with AAVF as final palliation. Nine patients underwent follow-up catheterization \u22656 months after AAVF, demonstrating significant improvement in pulmonary venous saturation, aortic saturation, and McGoon ratio (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.013, .012, and .011, respectively). Early postoperative SO\n                      <jats:sub>2<\/jats:sub>\n                      at 2 months strongly correlated with later SO\n                      <jats:sub>2<\/jats:sub>\n                      at 6, 12, 18, and 24 months (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.003, .004, .004, and .018, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Axillary arteriovenous fistula creation was effective in treating PAVMs in 75% (9\/12) of our patients and was effective as a bridge to total cavopulmonary connection (TCPC) in all patients. It may be considered an alternative to TCPC when TCPC is not feasible; however, this requires validation in a larger population with longer follow-up. Finally, mid-term SO\n                      <jats:sub>2<\/jats:sub>\n                      can be predicted based on the first 2 months of SO\n                      <jats:sub>2<\/jats:sub>\n                      post-AAVF creation, as there is excellent correlation between SO\n                      <jats:sub>2<\/jats:sub>\n                      at the first 2 postoperative months and SO\n                      <jats:sub>2<\/jats:sub>\n                      at 6, 12, 18, and 24 months\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501351261477042","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:38:09Z","timestamp":1790692689000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Axillary Arteriovenous Fistula for Resolution of Pulmonary Arteriovenous Malformations Following Bidirectional Superior Cavopulmonary Connections"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8797-5366","authenticated-orcid":false,"given":"Ibrahim J.","family":"Alibrahim","sequence":"first","affiliation":[{"name":"Ministry of National Guard Health Affairs"},{"name":"King Abdullah International Medical Research Center, Riyadh, Saudi Arabia"},{"name":"King Saud bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Alomrani","sequence":"additional","affiliation":[{"name":"Ministry of National Guard Health Affairs"},{"name":"King Abdullah International Medical Research Center, Riyadh, Saudi Arabia"},{"name":"King Saud bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7841-1593","authenticated-orcid":false,"given":"Abdulraouf M. Z.","family":"Jijeh","sequence":"additional","affiliation":[{"name":"Ministry of National Guard Health Affairs"},{"name":"King Abdullah International Medical Research Center, Riyadh, Saudi Arabia"},{"name":"King Saud bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed S.","family":"Kabbani","sequence":"additional","affiliation":[{"name":"Ministry of National Guard Health Affairs"},{"name":"King Abdullah International Medical Research Center, Riyadh, Saudi Arabia"},{"name":"King Saud bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"Alhabshan","sequence":"additional","affiliation":[{"name":"Ministry of National Guard Health Affairs"},{"name":"King Abdullah International Medical Research Center, Riyadh, Saudi Arabia"},{"name":"King Saud bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar R.","family":"Tamimi","sequence":"additional","affiliation":[{"name":"King Fahad Medical City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faleh","family":"Alqahtani","sequence":"additional","affiliation":[{"name":"Ministry of National Guard Health Affairs"},{"name":"King Abdullah International Medical Research Center, Riyadh, Saudi Arabia"},{"name":"King Saud bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Alghamdi","sequence":"additional","affiliation":[{"name":"Ministry of National Guard Health Affairs"},{"name":"King Abdullah International Medical Research Center, Riyadh, Saudi Arabia"},{"name":"King Saud bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1586\/14779072.2014.912132"},{"issue":"4","key":"e_1_3_2_3_2","first-page":"1011","article-title":"Should we always plan a Fontan completion after a Kawashima procedure?","volume":"40","author":"Setyapranata S","year":"2011","unstructured":"Setyapranata S, Brizard CP, Konstantinov IE, Iyengar A, Cheung M, d\u2019Udekem Y. Should we always plan a Fontan completion after a Kawashima procedure? Eur J Cardiothorac Surg. 2011;40(4):1011\u20131015.","journal-title":"Eur J Cardiothorac Surg"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezr003"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2005.04.043"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(96)00961-7"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)00450-8"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2005.05.100"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.4103\/apc.APC_144_19"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(96)70414-2"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/2150135115574532"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezx484"}],"container-title":["World Journal for Pediatric and Congenital Heart Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501351261477042","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21501351261477042","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501351261477042","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:50:32Z","timestamp":1790949032000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21501351261477042"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":11,"alternative-id":["10.1177\/21501351261477042"],"URL":"https:\/\/doi.org\/10.1177\/21501351261477042","relation":{},"ISSN":["2150-1351","2150-136X"],"issn-type":[{"value":"2150-1351","type":"print"},{"value":"2150-136X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"article-number":"21501351261477042"}}