Kawashima–Glenn Procedure
A Kawashima–Glenn procedure is a modified cavopulmonary connection in single-ventricle palliation in which systemic venous blood flow is directed to the pulmonary circulation using a superior cavopulmonary anastomosis while accounting for an interrupted inferior vena cava with azygos continuation. [1-3]
Relationship to the Glenn Procedure
The Kawashima–Glenn procedure is an adaptation of the Glenn-type superior cavopulmonary connection. [1-3]
Core Surgical Concept
The essential anatomic feature addressed by the Kawashima–Glenn procedure is interrupted IVC with azygos continuation, which causes venous drainage from the lower body (with hepatic venous drainage excluded) to reach the pulmonary circuit through the azygos system rather than through a normal IVC-to-atrium pathway. [1,2]
Physiologic Goal
The procedure decreases volume load on the single ventricle by diverting systemic venous return to the pulmonary circulation. [1-3]
Typical Staging Context
The superior cavopulmonary anastomosis component is part of staged palliation for single-ventricle physiology preceding completion of the Fontan circulation. [1-3]