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. A recent study suggests that this cyanosis will resolve following surgical redirection of hepatic veins into the cavopulmonary circulation (total right heart bypass operation).