Ask Dr. Z

Our cardiologist stated he did a "right heart catheterization and retrograde left heart catheterization" in a patient who has a history of AV canal defect with hypoplasia of the left ventricle, single atrium, single right ventricle, D-transposition of the great arteries, and subaortic stenosis with an interrupted inferior vena cava with azygos continuation into the SVC, status-post bulboventricular foramen enlargement, Damus-Kaye-Stansel procedure with placement of graft between the proximal pulmonary artery and the ascending aorta, as well as bilateral bidirectional Glenn shunt. At some point the patient also underwent an extracardiac Fontan completion. In the description of the procedure, access is gained in JV/FV/FA - does go into the Fontan, the Glenn anastomosis, into the right ventricle and into the (right?) atrium. We aren't sure if he truly has a single atrium or if it's just that the septum has been removed for the extracardiac Fontan (is that that done?). No left heart cath pressures are recorded. Is it because there isn't a left heart cath per se and one chamber is acting as systemic chamber? Is this really a left heart catheterization?