IP International Journal of Comprehensive and Advanced Pharmacology 2022;7(4):228–231 Content available at: https://www.ipinnovative.com/open-access-journals IP International Journal of Comprehensive and Advanced Pharmacology Journal homepage: https://www.ijcap.in/ Case Report Anaesthetic management of type II abernethy malformation posted for endovascular device closure Akshaya Narayan Shetti 1, *, Vijayakumar Ranganathan 2 , Abhishek H N 3 , Aarati Thakur 4 , Safdhar Hasmi R 5 , Rachita G Mustilwar 6 1 Dept. of Anaesthesiology and Critical Care, Dr. Balasaheb Vikhe Patil Rural Medical College, Loni, Maharashtra, India 2 Senior Consultant Cardiac Anaesthetist in KG Hospital, Coimbatore, Tamil Nadu, India 3 Dept. of Anaesthesiology, Vydehi Institute of Medical Sciences, Bangalore, Karnataka, India 4 Dept. of Anaesthesiology, Chinnamasta Hospital, Rajbiraj, Nepal 5 Dept. of Anesthesiology, King George’s Medical University, Lucknow, Uttar Pradesh, India 6 Dept. of Periodontics, Rural Dental College, PIMS, Loni, Maharashtra, India ARTICLE INFO Article history: Received 22-10-2022 Accepted 24-11-2022 Available online 13-01-2023 Keywords: Abernethy malformation ASD Cyanosis Endovascular device placement ABSTRACT Abernethy malformation is a rare congenital vascular malformation in which anomalous communication is seen between portal and systemic circulation. While treating the main goal is to prevent shunting of portal blood into the systemic circulation and preserving hepatic blood flow. This can be achieved surgically or non-surgical method. We report anaesthetic management of non-surgical closure of type II Abernethy malformation of 10 year old female child who had undergone ostium secundum ASD (atrial septal defect) patch closure. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. For reprints contact: reprint@ipinnovative.com 1. Introduction John Abernethy in 1793 described this malformation first time, when 10 month old child died of unknown cause. During post mortem examination he could find multiple congenital anomalies including, dextrocardia, polysplenia, portal vein joining inferior vena cava and transposition of great vessels. 1 Two variations are reported in this anomaly. 2 Type I includes congenital absence of portal vein with complete diversion of portal blood into inferior vena cava (IVC). This furthered classified as, type Ia in which superior mesenteric (SMV) and splenic vein (SV) separately drains into systemic veins and in Ib both SMV and SV join to form a short extra-hepatic portal vein (PV) and ultimately draining into IVC. Type II includes Presence of hypoplastic PV and portal blood is diverted into IVC through a side- * Corresponding author. E-mail address: aksnsdr@gmail.com (A. N. Shetti). to-side, extrahepatic communication. 3 The main key is to preserve portal blood flow to liver as much as possible while closing the shunt between portal and systemic circulation. 4 Very few pediatric cases have been reported from India. 5,6 As this is a rare entity and no reports are available on anaesthetic management of such a case for endovascular device closure hence it was challenging. Here we report anaesthetic management of type II abernethy malformation posted for endovascular closure who had undergone ASD correction. 2. Case presentation A 10-yr-old 25 kg child presented to our hospital, Dr Vithalrao Vikhe Patil Pravara Rural Hospital, Maharashtra, India, with the chief complaints of breathlessness on exertion suggestive of grade II NYHA (New York Heart Association) class and bluish discoloration of all fingers and https://doi.org/10.18231/j.ijcaap.2022.043 2581-5555/© 2022 Innovative Publication, All rights reserved. 228