Kawashima procedure is a palliative surgical procedure performed in cases of:
left isomerism and azygos continuation of the inferior vena cava
single functional ventricle
single atrium and common atrioventricular valve with or without regurgitation
pulmonary stenosis
It is performed by creation of a cavopulmonary anastomosis between superior vena cava and the pulmonary artery. However, many patients can develop progressive cyanosis likely attributed to the development of multiple microscopic pulmonary arteriovenous malformations. One study suggests that this cyanosis will resolve following surgical redirection of hepatic veins into the cavopulmonary circulation (total right heart bypass operation) 1.
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