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Right to left shunt due to abnormal systemic venous drainage to the heart or the pulmonary veins is among the causes of hypoxemia following the Fontan operation. There are conflicting data regarding the closure of the venovenous collateral (VVC) vessels post-Fontan. The embolization of these VVC in older patients may be associated with decreased survival. We describe a rare fistula draining a right-sided hepatic vein connected to a hepatic venous plexus to a right-sided pulmonary venous atrium in a child with visceral heterotaxy. The patient presented with severe hypoxemia following the Fontan operation. The fistula was successfully occluded by an AMPLATZERTM Vascular Plug II to resolve the hypoxemia and improve the

Transcatheter Occlusion of a Hepatic Vein to left Atrium Fistula: Should we close Venovenous collateral Vessels following Fontan operation?