TheKawashima procedure is used forcongenital heart disease with a single effective ventricle and aninterruptedinferior vena cava (IVC). It was first performed in 1978 and reported in 1984.^[1]

Technically it is very similar to thebidirectional Glenn procedure used to direct half the body's venous blood flow into the lungs. However, in patients with interrupted IVC, most of the blood from the lower body actually joins the blood from the upper body before returning to the heart via thesuperior vena cava (SVC). Therefore, the redirection of SVC blood to the lungs (as in the Glenn) results in much more than half the venous blood flow being diverted.^{[citation needed]}

After Kawashima, the only de-oxygenated blood returning to the heart is from the abdominal organs (via thehepatic veins). As a result, there is much lesshypoxia than after Glenn, and the heart is pumping less additional blood than after Glenn. However, the hypoxia can worsen over time (because of the development of microscopicAVMs in the lungs that allow blood to pass through without being oxygenated),^[2] and therefore these children still may need a completeFontan procedure in the end.^[3][4]

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