2,031 results on '"Vena Cava, Superior abnormalities"'
Search Results
2. Author's reply to Optimal Pacemaker Implantation in Patients with Isolated Persistent Left Superior Vena Cava.
- Author
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Hata T, Kato K, Kamiya K, Okuyama Y, Fujii Y, Yagi N, Ozawa T, and Nakagawa Y
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- Humans, Vena Cava, Superior abnormalities, Vena Cava, Superior diagnostic imaging, Pacemaker, Artificial, Persistent Left Superior Vena Cava complications, Persistent Left Superior Vena Cava therapy, Persistent Left Superior Vena Cava diagnostic imaging
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- 2024
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3. Major issues for supraventricular tachycardia ablation in patients with persistent left superior vena cava.
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Pellegrini N, Bolzan B, Franchi E, Tomasi L, Ribichini FL, and Mugnai G
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- Humans, Male, Female, Treatment Outcome, Vena Cava, Superior surgery, Vena Cava, Superior abnormalities, Vena Cava, Superior diagnostic imaging, Catheter Ablation methods, Tachycardia, Supraventricular surgery, Persistent Left Superior Vena Cava surgery, Persistent Left Superior Vena Cava diagnostic imaging, Persistent Left Superior Vena Cava complications
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- 2024
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4. RF catheter ablation of AVNRT in a patient with interrupted inferior vena cava anomaly with hemiazygos continuity with persistent left superior vena cava.
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Bozorgi A, Tabesh F, Jahangiri M, Rabiei P, and Mehrabi Nasab E
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- Adult, Female, Humans, Azygos Vein abnormalities, Azygos Vein surgery, Vena Cava, Superior abnormalities, Vena Cava, Superior surgery, Catheter Ablation methods, Persistent Left Superior Vena Cava surgery, Persistent Left Superior Vena Cava complications, Tachycardia, Atrioventricular Nodal Reentry surgery, Tachycardia, Atrioventricular Nodal Reentry physiopathology, Vena Cava, Inferior abnormalities, Vena Cava, Inferior surgery
- Abstract
Intrahepatic interruption of the inferior vena cava (IVC) with continued hemizygous is a very rare abnormality and sometimes it may be accompanied by other cardiovascular abnormalities. Continuation of the hemizygous vein draining into the right atrium through the left superior vena cava (LSVC) is much rarer. In this paper, we have presented a patient who had simultaneous IVC interrupted with persistent LSVC and suffered from Atrioventricular nodal reentrant tachycardia (AVNRT). Finally, radiofrequencies (RF) catheter ablation for AVNRT was successfully performed through a left subclavian vein access., (© 2024. The Author(s).)
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- 2024
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5. Persistent left superior vena cava: clinical and radiological significance.
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Cobo Ruiz T and Peña Gómez ME
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- Humans, Male, Female, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior abnormalities, Middle Aged, Adult, Persistent Left Superior Vena Cava diagnostic imaging, Persistent Left Superior Vena Cava complications
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- 2024
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6. Transcatheter Correction of Superior Venacaval Form of Sinus Venosus Defects Using Balloon-Mounted Covered STENTS.
- Author
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Sivakumar K
- Subjects
- Humans, Heart Septal Defects, Atrial surgery, Prosthesis Design, Vena Cava, Superior abnormalities, Vena Cava, Superior surgery, Cardiac Catheterization methods, Stents
- Abstract
Superior sinus venosus defects (SVD) are interatrial communications located above the confines of the oval fossa, where unroofing of the right upper pulmonary vein leads to its anomalous drainage to the superior venacava. Recent emergence of transcatheter closure of these defects using covered stents is an attractive alternative option especially in adults with additional comorbidities. This article focuses on various aspects of non-surgical closure of SVD, including patient selection, appropriate hardware options, step-by-step procedural details, evolution and modifications in the techniques over the last decade, protocols for follow-up evaluation, and potential complications associated with this intervention., Competing Interests: Disclosure The author has nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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7. Ischemic Heart Disease with In-Stent Re-Stenosis with Complete Heart Block and Isolated Persistent Left Superior Vena Cava - Rare Case Report with Challenges and Clinical Implications.
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Yedurupaka SS, Raj BSS, and Prasad RMV
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- Humans, Male, Angioplasty, Balloon, Coronary methods, Vena Cava, Superior abnormalities, Vena Cava, Superior diagnostic imaging, Middle Aged, Stents, Myocardial Ischemia surgery, Heart Block therapy, Persistent Left Superior Vena Cava complications
- Abstract
Abstract: Isolated persistent left superior vena cava (PLSVC) is a very rare congenital thoracic venous system anomaly and is commonly an incidental finding, usually detected during central venous access, cardiac catheterization, or cardiothoracic surgeries. This is a rare case report wherein the patient is a known case of ischemic heart disease with s/p percutaneous transluminal coronary angioplasty (PTCA) with a stent to left anterior descending (LAD) artery with in-stent re-stenosis presented with complete heart block and had an unanticipated discovery of isolated PLSVC on facing difficulty during the transvenous approach of permanent pacemaker implantation (PPI). In this case report, we inspect the challenges associated with and various clinical implications of isolated PLSVC., (Copyright © 2024 Copyright: © 2024 Annals of Cardiac Anaesthesia.)
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- 2024
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8. A Double Rarity: Lost intravascular Catheter Guidewire in Persistent Left Superior Vena Cava and Coronary Sinus - A Case Report.
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Palić B, Goluža Sesar M, Galić K, Bogdan G, and Prskalo Z
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- Humans, Male, Aged, Treatment Outcome, Catheters, Indwelling, Vena Cava, Superior abnormalities, Vena Cava, Superior diagnostic imaging, Phlebography, Coronary Sinus abnormalities, Coronary Sinus diagnostic imaging, Catheterization, Central Venous instrumentation, Catheterization, Central Venous adverse effects, Central Venous Catheters, Persistent Left Superior Vena Cava complications, Persistent Left Superior Vena Cava diagnostic imaging, Persistent Left Superior Vena Cava therapy, Device Removal
- Abstract
Guidewire loss is a rare complication of central venous catheterization. A 65-year-old male was hospitalized in a high-dependency unit for exacerbation of chronic obstructive pulmonary disease, pneumonia, erythrocytosis, and clinical signs of heart failure. Upon admission, after an unsuccessful right jugular approach, a left jugular central venous catheter was placed. The next day, chest radiography revealed the catheter located in the left parasternal region, with suspected retention of the guidewire, visually confirmed by the presence of its proximal end inside the catheter. The left parasternal location of the catheter and the typical projection of the guidewire in the coronary sinus, later confirmed by echocardiography, raised suspicion of a persistent left superior vena cava (PLSVC). Agitated saline injected into the left antecubital vein confirmed bubble entry from the coronary sinus into the right atrium. After clamping the guidewire, the catheter was carefully retrieved along with the guidewire without any complications. This is the first reported case of guidewire retention in PLSVC and coronary sinus. It underscores the potential causes of guidewire loss and advocates preventive measures to avoid this potentially fatal complication., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© 2024 Palić et al.)
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- 2024
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9. Prenatal Detection and Postnatal Outcome of Persistent Left Superior Vena Cava and Agenesis of Ductus Venosus Associated with Postnatal Bovine Aortic Arch.
- Author
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Elbistanli C, Yozgat Y, Dogan MS, Yozgat CY, and Kütük MS
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- Female, Humans, Pregnancy, Adult, Infant, Newborn, Persistent Left Superior Vena Cava diagnostic imaging, Persistent Left Superior Vena Cava complications, Abnormalities, Multiple diagnostic imaging, Umbilical Veins abnormalities, Umbilical Veins diagnostic imaging, Vena Cava, Superior abnormalities, Vena Cava, Superior diagnostic imaging, Echocardiography, Male, Aorta, Thoracic abnormalities, Aorta, Thoracic diagnostic imaging, Aorta, Thoracic embryology, Ultrasonography, Prenatal
- Abstract
Background: Isolated agenesis of ductus venosus (ADV) is usually a benign condition, but it may be associated with cardiovascular defects, hydrops, growth restriction, and chromosomal abnormalities. Additionally, persistent left superior vena cava (PLSVC) and bovine aortic arch are relatively common fetal anomalies. To the author's knowledge, this is the first report of prenatal detection of DV agenesis and PLSVC associated with the postnatal bovine aortic arch with a hypoplastic transverse aortic arch., Case: A 25-year-old, G2P1 woman was referred to our department at 31 weeks due to fetal growth restriction and short femur. On fetal echocardiography, DV could not be viewed via two-dimensional (2D) and Doppler ultrasound (US) imaging; there was also evidence of the co-occurrence of PLSVC and an aortic arch anomaly. We revealed the intrahepatic continuation of the umbilical vein. A weekly follow-up program was scheduled for the patient and the rest of the pregnancy was uneventful. Postnatal, thorax computer tomography and transthoracic echocardiography (TTE) demonstrated PLSVC and bovine aortic arch associated with hypoplastic transverse aortic arch. Routine echocardiographic examinations revealed that the blood flow of the aortic arch had increased gradually, and the male infant's aortic arch had significantly widened and reached the normal range until the baby was discharged from the hospital., Conclusion: DV agenesis and PLSVC are usually benign conditions but underlying serious heart diseases may accompany them. Therefore, in situations like ours, a prenatal aortic arch evaluation is of capital importance. Postnatal hemodynamic changes should be taken into consideration in the management of these cases. This is the first example in the literature that these abnormalities co-existed in one case., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)
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- 2024
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10. Challenge Accepted: Lead Extraction in a Patient with Persistent Left Superior Vena Cava and Right Superior Vena Cava Occlusion.
- Author
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Alkalbani M, Luu V, and Arshad A
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- Female, Humans, Male, Defibrillators, Implantable, Pacemaker, Artificial, Persistent Left Superior Vena Cava surgery, Persistent Left Superior Vena Cava diagnostic imaging, Device Removal, Superior Vena Cava Syndrome surgery, Superior Vena Cava Syndrome diagnostic imaging, Vena Cava, Superior abnormalities, Vena Cava, Superior surgery, Vena Cava, Superior diagnostic imaging
- Abstract
Persistent left superior vena cava (PLSVC) is an anatomic variant that is relatively uncommon in the general population. Lead extraction through PLSVC is extremely rare. Due to unusual anatomy, the procedure carries challenges that require special considerations and careful planning. The authors report a case of lead extraction through a PLSVC with occluded right superior vena cava and highlight the challenges and outcomes of the procedure., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Published
- 2024
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11. Persistent Left Superior Vena Cava with the Absence of the Right Superior Vena Cava and Atrial Appendage: Complex Pacemaker Implantation in a Patient Presenting with a Rare Vascular Anomaly.
- Author
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Hata T, Kato K, Kamiya K, Okuyama Y, Fujii Y, Yagi N, Ozawa T, and Nakagawa Y
- Subjects
- Humans, Tomography, X-Ray Computed, Male, Female, Aged, Vascular Malformations complications, Vascular Malformations diagnostic imaging, Vascular Malformations diagnosis, Pacemaker, Artificial, Atrial Appendage diagnostic imaging, Atrial Appendage abnormalities, Persistent Left Superior Vena Cava complications, Persistent Left Superior Vena Cava diagnostic imaging, Vena Cava, Superior abnormalities, Vena Cava, Superior diagnostic imaging, Sick Sinus Syndrome therapy
- Abstract
A persistent left superior vena cava (PLSVC) is a commonly observed anatomical anomaly that is frequently detected incidentally via computed tomography (CT) imaging. However, the occurrence of a PLSVC with a right superior vena cava (RSVC) defect, also known as "isolated PLSVC," is a much rarer anomaly. This peculiar malformation can lead to sinoatrial dysfunction, thus necessitating pacemaker implantation, which requires delicate manipulation due to various anatomical complexities. We herein present a case of a sick sinus syndrome with this rare anomaly, which required special consideration when performing pacemaker lead placement.
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- 2024
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12. NASCI case of the month: "Unroofed coronary sinus without persistent left-sided superior vena cava".
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Asfaw EK, Agarwal PP, and Lee EM
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- Humans, Computed Tomography Angiography, Coronary Angiography, Coronary Vessel Anomalies diagnostic imaging, Phlebography methods, Vena Cava, Superior abnormalities, Vena Cava, Superior diagnostic imaging, Coronary Sinus abnormalities, Coronary Sinus diagnostic imaging, Coronary Sinus physiopathology, Predictive Value of Tests
- Abstract
Unroofed sinus is categorized into four subtypes. Types I and II represent complete unroofing with or without an LSVC, respectively [1]. Types III and IV are partial unroofing involving the mid-CS (type III) or near the LA appendage and left superior pulmonary vein (type IV) [1]. CT has advantages over echocardiography in detection of this anomaly (illustrated in this case) as well as in precise delineation of defect and associated findings (presence or absence of LSVC). Short axis reconstructions at the level of CS are helpful in diagnosis. Considerations for repair include location of CS defect, presence of LSVC and other abnormalities as well as comorbidity risks [2]., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)
- Published
- 2024
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13. Transthoracic Echocardiography-Guided Placement of a Pulmonary Artery Catheter in a Patient With a Known Persistent Left but Unknown Absent Right Superior Vena Cava.
- Author
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Leclerc JL, Clemes R, Fuss C, Macon CJ, and Schulman PM
- Subjects
- Humans, Male, Echocardiography methods, Persistent Left Superior Vena Cava complications, Persistent Left Superior Vena Cava diagnostic imaging, Pulmonary Artery diagnostic imaging, Pulmonary Artery abnormalities, Ultrasonography, Interventional methods, Adult, Catheterization, Swan-Ganz instrumentation, Catheterization, Swan-Ganz methods, Vena Cava, Superior abnormalities, Vena Cava, Superior diagnostic imaging
- Abstract
Competing Interests: Disclosures None.
- Published
- 2024
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- View/download PDF
14. It's a long way to the top! Congenital venous anomalies and left isomerism limiting atrial fibrillation transcatheter ablation.
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De Innocentiis C, Buonpane A, Totaro A, Restaino G, Astore P, Guarino M, Langella V, Gallina S, and Santamaria M
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- Humans, Isomerism, Treatment Outcome, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior surgery, Vena Cava, Superior abnormalities, Atrial Fibrillation surgery, Catheter Ablation methods
- Abstract
Background: Atrial fibrillation is the most common sustained cardiac arrhythmia in adults and it is associated with a high burden of mortality and morbidity worldwide. Catheter ablation is increasingly used to improve symptoms and prognosis in selected patients. Lower limb venous access with subsequent transseptal approach to the left atrium is the standard procedure for atrial fibrillation catheter ablation., Case Presentation: We report an unusual case of complex venous anomaly with a left-sided inferior vena cava with hemiazygos continuation to a persistent left superior vena cava draining in an enlarged coronary sinus in a patient with persistent atrial fibrillation scheduled for transcatheter ablation., Discussion: Lower limb venous anomalies may limit a standard transseptal approach to the left atrium thus precluding an effective catheter ablation procedure for atrial fibrillation. Alternative interventions, such as unconventional percutaneous access, thoracoscopic approach and "ablate and pace" procedures, may be necessary in patients with symptomatic atrial fibrillation and complex venous anomalies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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15. Catheter ablation of the left-sided variant of right top pulmonary vein in a case with persistent left superior vena cava.
- Author
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Nakatani Y, Take Y, Takizawa R, Yoshimura S, Kaseno K, Yamashita E, and Naito S
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- Humans, Female, Middle Aged, Tomography, X-Ray Computed, Vena Cava, Superior abnormalities, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior surgery, Pulmonary Veins abnormalities, Pulmonary Veins surgery, Pulmonary Veins diagnostic imaging, Catheter Ablation methods, Atrial Fibrillation surgery, Persistent Left Superior Vena Cava surgery, Persistent Left Superior Vena Cava diagnostic imaging
- Abstract
A 50-year-old woman underwent catheter ablation for atrial fibrillation. Preoperative computed tomography revealed a left-sided variant of the right top pulmonary vein (PV) and a persistent left superior vena cava. The right top PV was successfully isolated through a wide antral circumferential ablation line simultaneously with the right PVs., (© 2023 Wiley Periodicals LLC.)
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- 2024
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16. A rare case of isolated persistent left superior vena cava diagnosed by echocardiography.
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Smolarek D, Jankowska H, Dorniak K, and Hellmann M
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- Male, Humans, Adult, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior abnormalities, Echocardiography, Dilatation, Pathologic, Persistent Left Superior Vena Cava, Vascular Malformations diagnostic imaging, Coronary Sinus diagnostic imaging
- Abstract
Background: The persistent left superior vena cava (PLSVC) is an infrequent vascular variant. PLSVC with absent right superior vena cava, also known as isolated PLSVC, is an exceptionally rare entity. In this case we present a patient with isolated PLSVC draining to coronary sinus, diagnosed incidentally during echocardiography., Case Presentation: A 35-year-old man underwent a transthoracic echocardiography which showed an enormously dilated coronary sinus. Hand-agitated saline was injected via peripheral intravenous cannulas. The contrast appeared firstly in the coronary sinus before it opacified the right atrium. Since this was also visible by the right antecubital saline injection, it indicated an extremely rare case of PLSVC with the absence of right superior vena cava which was confirmed by cardiac magnetic resonance., Conclusions: The finding of a distinctively dilated coronary sinus in echocardiography led us to further investigation using agitated saline that revealed an infrequent anomaly termed isolated PLSVC. The in-depth diagnosis of this vascular variant is crucial considering that it may lead to important clinical implications, such as difficulties with central venous access, especially in the current era of a rapid development of cardiac device therapies., (© 2024. The Author(s).)
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- 2024
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17. Rare case of total anomalous pulmonary venous return into the right atrium in situs solitus.
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Caruso E, Farruggio S, and Silverman NH
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- Humans, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior abnormalities, Heart Atria diagnostic imaging, Heart Atria abnormalities, Scimitar Syndrome diagnostic imaging, Pulmonary Veins diagnostic imaging, Pulmonary Veins abnormalities, Heart Septal Defects, Atrial diagnosis, Heart Septal Defects, Atrial diagnostic imaging
- Abstract
We report an uncommon case report of total anomalous pulmonary venous returns into the right atrium at the base of the superior caval vein's ostium without a sinus venosus defect, in situs solitus, without vertical vein or a posterior pulmonary venous confluence.
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- 2024
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18. Mal-positioning of a dialysis catheter: One lumen with arterial blood and the other with venous blood?
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Ávila G, Matias P, Marques L, Laranjinha I, Carvalho T, Mendes A, and Gil C
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- Female, Humans, Middle Aged, Renal Dialysis, Catheterization, Heart Atria, Catheters, Jugular Veins, Vena Cava, Superior abnormalities, Catheterization, Central Venous methods
- Abstract
Partial anomalous pulmonary vein drainage is a rare congenital defect, where the pulmonary vein drains into a systemic vein instead of draining into the left atrium. We present a case of a 63-year-old woman on hemodialysis who was found to have a right pulmonary vein with anomalous drainage to the superior vena cava after mal-positioning of a dialysis catheter, which demonstrated unexpected blood results from the different lumina of the catheter. Multiple imaging techniques were used to deal with this rare clinical situation. This is the first case reporting a mal-positioning of a left-side internal jugular vein tunneled catheter into a right-side pulmonary vein., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2024
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19. Persistant Left Superior Vena Cava with and Without Right Superior Vena Cava: Significance of Prenatal Diagnosis.
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Kahramanoglu O, Demirci O, Uygur L, Erol N, Schiattarella A, and Rapisarda AMC
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- Pregnancy, Female, Humans, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior abnormalities, Retrospective Studies, Ultrasonography, Prenatal methods, Prenatal Diagnosis, Persistent Left Superior Vena Cava, Vascular Malformations diagnostic imaging, Vascular Malformations epidemiology, Heterotaxy Syndrome
- Abstract
This study aims to define the associated anomalies with PLSVC, and to compare single PLSVC and bilateral superior vena cava in terms of accompanying anomalies and pregnancy outcomes. This was a retrospective study of the fetuses diagnosed with single and/or bilateral SVC at a tertiary fetal medicine center during 8 years. We detected 16 cases of single PLSVC and 84 cases of bilateral SVC. We found an association between the PLSVC and cardiac and extracardiac anomalies. Comparison between single PLSVC and BSVC cases revealed significant differences in the occurrence of heterotaxy and right isomerism. The study highlights the importance of prenatal diagnosis in PLSVC cases. Isolated PLSVC with situs solitus may be considered a benign finding, but larger studies are needed to understand the clinical implications of PLSVC in relation to chromosomal anomalies. Routine screening protocols should include three-vessel and trachea views to detect PLSVC., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Published
- 2024
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20. Intracardiac Echocardiogram from Persistent Left Superior Vena Cava.
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Garg J, Kewcharoen J, Contractor T, Mandapati R, and Bhardwaj R
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- Humans, Vena Cava, Superior abnormalities, Vena Cava, Superior diagnostic imaging, Echocardiography methods, Persistent Left Superior Vena Cava diagnostic imaging, Persistent Left Superior Vena Cava complications
- Abstract
Competing Interests: Declaration of Competing Interest The authors have no competing interests to declare.
- Published
- 2024
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21. Absent Superior Vena Cava: An Uncommon Cause of Anomalous Systemic Venous Return.
- Author
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Kaskar A, Sheth K, Paanwala H, Khan N, and Kumar G
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- Male, Humans, Infant, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior surgery, Vena Cava, Superior abnormalities, Tomography, X-Ray Computed
- Abstract
We report a case of a one-year-old boy with tetralogy of Fallot, who was preoperatively diagnosed to have an associated systemic venous anomaly. Computed tomography confirmed the absent superior vena cava, and the case was managed with an appropriate cannulation strategy. Preoperative diagnosis and thorough planning of this rather benign anomaly were imperative for the successful outcome of this case. Clinical and surgical implications of this anomaly are discussed in this report., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2024
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22. Increased Pulmonary-Aortic Interspace in Fetal Right Aortic Arch: A Matched Case-Control Study.
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Bet BB, van Steijn AE, Linskens IH, Knobbe I, van Leeuwen E, Pajkrt E, and Clur SA
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- Humans, Female, Case-Control Studies, Pregnancy, Adult, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior embryology, Vena Cava, Superior abnormalities, Aorta, Thoracic diagnostic imaging, Aorta, Thoracic embryology, Aorta, Thoracic abnormalities, Pulmonary Artery diagnostic imaging, Pulmonary Artery embryology, Pulmonary Artery abnormalities, Ultrasonography, Prenatal methods
- Abstract
Introduction: The prenatal detection rate of a right aortic arch (RAA) has increased with the implementation of the three-vessel view (3VV) to the second-trimester anomaly scan formed by the pulmonary artery (PA), aorta (Ao), and superior vena cava (SVC). We examined the value of measuring the distance between PA and Ao in the 3VV in cases with an RAA., Methods: We conducted a case-control study in which fetuses with an isolated RAA were matched to 3 healthy controls. Using 3VV images, the distances between PA, Ao, and SVC were measured and the ratio between PA to Ao (PAAo) distance and Ao to SVC (AoSVC) distance was calculated., Results: Fifty-four RAA cases and 162 matched controls were included. The mean absolute distance PAAo was 3.1 mm in cases and 1.8 mm in controls (p < 0.001), and the mean PAAo/AoSVC ratio was 2.9 and 1.4, respectively (p < 0.001). The ROC curve of PAAo/AoSVC ratio showed a cut-off point of 1.9 with sensitivity and specificity over 87% for the diagnosis of RAA., Conclusions: The pulmonary-aortic interspace and the PAAo/AoSVC ratio were significantly larger for RAA cases as compared to controls. If an increased pulmonary-aortic interspace is observed, a PAAo/AoSVC of ≥1.9 can be helpful in the diagnosis of an RAA., (© 2024 The Author(s). Published by S. Karger AG, Basel.)
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- 2024
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23. Interrupted inferior vena cava draining into the coronary sinus associated with circumflex artery to coronary sinus fistula.
- Author
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Calafiore AM, Totaro A, Pierro A, Sacra C, Prapas S, Katsavrias K, and Testa G
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- Humans, Adult, Vena Cava, Superior abnormalities, Coronary Vessels diagnostic imaging, Coronary Vessels surgery, Vena Cava, Inferior surgery, Vena Cava, Inferior abnormalities, Coronary Sinus surgery, Heart Defects, Congenital, Fistula
- Abstract
In an adult patient, coronary artery fistula involving the circumflex artery (CX) connected to the coronary sinus caused aneurysm of the left main and CX associated with ectasia of the intermediate branch. The patient had posterolateral infarction with severe ischemic mitral regurgitation and moderate tricuspid regurgitation. A rare venous return anomaly was also present. The inferior vena cava, which was interrupted at the level of the liver, continued with the hemiazygos to drain into a persistent left superior vena cava, which in turn drained into the coronary sinus. Surgery included CX closure and mitral and tricuspid repair. The strategy had to be adapted to the anatomy. The fistula was dissected and snared for cardioplegia delivery, and venous return was achieved by cannulation of the superior vena cava and femoral vein. The procedure was uneventful, and 4 years later the patient is asymptomatic., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article., (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Published
- 2024
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24. Reintervention for Superior Vena Cava Obstruction After Heart Transplant.
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Aronowitz DI, Geoffrion TR, Burstein D, White RM, McHugh-Grant S, Mavroudis CD, Nuri MAK, Maeda K, Chen JM, Mascio CE, Gaynor JW, and Fuller S
- Subjects
- Child, Humans, Vena Cava, Superior surgery, Vena Cava, Superior abnormalities, Retrospective Studies, Heart Atria, Superior Vena Cava Syndrome etiology, Superior Vena Cava Syndrome surgery, Heart Transplantation adverse effects
- Abstract
Background: Children undergoing orthotopic heart transplant (OHT) may require complex reconstruction of superior vena cava (SVC) anomalies. SVC anatomy and mode of reconstruction are potential risk factors for SVC obstruction., Methods: A retrospective single-center review was conducted of patients undergoing initial OHT between January 1, 1990, and July 1, 2021. Simple SVC anatomy included a single right SVC to the right atrium or bilateral SVCs with a left SVC to an intact coronary sinus, without prior superior cavopulmonary connection. Presence of anomalous SVC anatomy, superior cavopulmonary connection, or previous atrial switch operation defined complex anatomy. Reconstructive strategies included atrial anastomosis; direct SVC-to-SVC anastomosis; and augmented SVC anastomosis using innominate vein, patch, cavopulmonary connection, or interposition graft. The primary outcome was reintervention for SVC obstruction., Results: Of 288 patients, pretransplant diagnoses included congenital heart disease (n = 155 [54%]), cardiomyopathy (n = 125 [43%]), and other (n = 8 [3%]). Most (n = 208 [72%]) had simple SVC anatomy compared with complex SVC anatomy (80 [28%]). Reintervention for SVC obstruction occurred in 15 of 80 (19%) with complex anatomy and 1 of 208 (0.5%) with simple anatomy (P = .0001). Reintervention was more common when innominate vein or a patch was used (9/25 [36%]) compared with an interposition graft (1/7 [14%]) or direct anastomosis (6/82 [7%]; χ
2 = 13.1; P = .001). Most reinterventions occurred within 30 days of OHT (14/16 [88%])., Conclusions: Patients with complex SVC anatomy have a higher rate of reintervention for SVC obstruction after OHT compared with those with simple SVC anatomy. In cases of complex SVC anatomy, interposition grafts may be associated with less reintervention compared with complex reconstructions using donor tissue., (Copyright © 2024 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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25. The Sinus Venosus Veno-Venous Bridge: Not a septal defect.
- Author
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Maddali MM, Anderson RH, Al Maskari SN, Al Kindi F, and Al Kindi HN
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- Humans, Vena Cava, Superior abnormalities, Heart Atria, Heart Septal Defects, Atrial surgery, Pulmonary Veins surgery, Pulmonary Veins abnormalities
- Abstract
This review provides an update on the morphology of the sinus venosus defect. It was earlier believed that a 'common wall' separated the right pulmonary veins from the superior caval vein. In the sinus venosus defects, this wall was absent. Current evidence shows that the superior rim of the oval fossa, rather than forming a second septum or representing a common wall, is an infolding between the walls of the caval veins and the right pulmonary veins. The sinus venosus defect is caused by the anomalous connection of one or more pulmonary veins to a systemic vein. However, the pulmonary vein(s) retain their left atrial connections, leading to a veno-venous bridge that allows interatrial shunting outside the oval fossa. True atrial septal defects are located within the oval fossa or in the anteo-inferior buttress, while sinus venosus defects, ostium defects and coronary sinus defects are morphologically distinct from them., (© Copyright 2023, Sultan Qaboos University Medical Journal, All Rights Reserved.)
- Published
- 2023
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26. Surgical treatment of anomalous right upper lobe pulmonary vein obstruction caused by compression between pulmonary artery and trachea: a case report.
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Zhang B, Xia J, and Wang X
- Subjects
- Humans, Vena Cava, Superior abnormalities, Pulmonary Artery diagnostic imaging, Pulmonary Artery surgery, Trachea diagnostic imaging, Trachea surgery, Pulmonary Veins surgery, Pulmonary Veins abnormalities, Vascular Malformations complications, Vascular Malformations diagnosis, Vascular Malformations surgery
- Abstract
The normal anatomical course of right upper lobe pulmonary vein involves drainage anteriorly to the pulmonary artery, ultimately reaching the left atrium. However, anomalies can occur with the most common variation involving the convergence of the right upper lobe pulmonary vein with the superior vena cava. In a rare pulmonary vascular malformation, the anomalous right upper lobe pulmonary vein takes a path between the right pulmonary artery and right main bronchus
[1] . During a clinical consultation, a patient presented in our hospital with this specific anomalous right upper lobe pulmonary vein, along with an atrial septal defect and a patent ductus arteriosus. As a consequence of this aberrant positioning, the right upper lobe pulmonary vein was compressed between the pulmonary artery and trachea, leading to pulmonary vein obstruction. Thus, a successful pulmonary vein replantation was performed to correct the congenital malformation.- Published
- 2023
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27. Giant right atrial aneurysm associated with persistent left cranial vena cava in a cat.
- Author
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Block CL and Tong NM
- Subjects
- Female, Cats, Animals, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior abnormalities, Vena Cava, Superior pathology, Cardiomegaly veterinary, Atrial Fibrillation veterinary, Aneurysm complications, Aneurysm diagnostic imaging, Aneurysm veterinary, Heart Defects, Congenital diagnosis, Heart Defects, Congenital veterinary, Cat Diseases diagnostic imaging
- Abstract
A 10-month-old female spayed Scottish Fold was referred to cardiology for incidental radiographic cardiomegaly. Echocardiography was suspicious for a right atrial or right auricular aneurysm. The differential diagnosis also included peritoneal-pericardial diaphragmatic hernia, mass lesion (cyst, granuloma, or neoplasia), or cardiac malformation. A giant right atrial aneurysm associated with a persistent left cranial vena cava was subsequently confirmed with computed tomography., (Copyright © 2023 Elsevier B.V. All rights reserved.)
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- 2023
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28. High prevalence of left superior vena cava and congenital heart disease in patients with pre- and postnatally diagnosed esophageal atresia/tracheoesophageal fistula.
- Author
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Parekh S, Ochotny R, Lazow SP, Ben-Ishay O, Aribindi V, Pluchinotta FR, Tworetzky W, Buchmiller TL, Peyvandi S, and Moon-Grady AJ
- Subjects
- Humans, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior abnormalities, Prevalence, Tracheoesophageal Fistula diagnostic imaging, Tracheoesophageal Fistula epidemiology, Esophageal Atresia diagnostic imaging, Esophageal Atresia epidemiology, Heart Defects, Congenital diagnostic imaging, Heart Defects, Congenital epidemiology
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- 2023
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29. Stroke Caused by a Paradoxical Embolus From a Rare Congenital Anomaly in the Adult: Persistent Left Superior Vena Cava Draining into the Left Upper Pulmonary Vein.
- Author
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Loube DK, Sreekrishnan A, Woo JP, Shen J, Collins RT, and Schwartz N
- Subjects
- Humans, Adult, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior abnormalities, Pulmonary Veins diagnostic imaging, Pulmonary Veins abnormalities, Persistent Left Superior Vena Cava complications, Stroke diagnostic imaging, Stroke etiology, Embolism complications
- Abstract
Competing Interests: Disclosures None.
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- 2023
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30. Identifying Anomalies of Systemic Venous Drainage: Systemic Venous Anomalies; Atrial Morphology.
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Maddali MM, Al Kindi HN, Kandachar PS, Al Farqani A, Al Alawi KS, Al Kindi F, Al-Maskari SN, Spicer DE, and Anderson RH
- Subjects
- Humans, Vena Cava, Superior abnormalities, Heart Atria abnormalities, Drainage, Pulmonary Veins abnormalities, Atrial Fibrillation, Heart Septal Defects, Atrial diagnostic imaging, Heart Septal Defects, Atrial surgery, Vascular Malformations diagnostic imaging
- Abstract
So as to produce totally anomalous systemic venous connection, all of the systemic venous tributaries, along with the coronary sinus, should be connected with the morphologically left atrium. Previous descriptions of this rare constellation of anomalous connections of the systemic venous tributaries of the heart have been compromised by the inclusion of individuals having isomeric atrial appendages. In these settings, most frequently, the totally, or almost totally, anomalous systemic venous connections are associated with a sinus venosus defect. It is the anomalous pulmonary venous connections that then create a venovenous bridge, which permits the systemic venous tributaries to drain into the morphologically left atrium, even though they may be predominantly connected to the right atrium. More rarely, it is feasible for the primary atrial septum to develop so as to leave the systemic venous sinus in direct connection with the body of the morphologically left, rather than the morphologically right, atrium. We report a series of patients potentially falling into the category of anomalous systemic venous connections. The findings show a spectrum from partially to totally anomalous connections, with some better interpreted on the basis of anomalous drainage. Included in our cases, nonetheless, is an autopsied example of totally anomalous systemic venous connection produced by an abnormal location of the primary atrial septum. We discuss the potential morphogenesis for this finding. We emphasize the distinction that needs to be made between anomalous systemic venous connections and anomalous systemic venous drainage.
- Published
- 2023
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31. Persistent left superior vena cava draining into the unroofed coronary sinus in a patient with tetralogy of Fallot and coronary sinus orifice atresia.
- Author
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Selcuk A, Korun O, and Sasmazel A
- Subjects
- Male, Humans, Infant, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior surgery, Vena Cava, Superior abnormalities, Tetralogy of Fallot complications, Tetralogy of Fallot surgery, Persistent Left Superior Vena Cava complications, Coronary Sinus diagnostic imaging, Coronary Sinus surgery, Coronary Sinus abnormalities, Heart Defects, Congenital complications, Heart Septal Defects, Atrial complications, Coronary Vessel Anomalies complications, Coronary Vessel Anomalies diagnosis, Coronary Vessel Anomalies surgery
- Abstract
Introduction: In this study, we present a case of directing persistent left superior vena cava drainage into the unroofed coronary sinus to the right atrium in a patient with tetralogy of Fallot and coronary sinus orifice atresia without innominate vein., Case Report: A 16-month-old boy diagnosed with tetralogy of Fallot was admitted. Following intracardiac repair, the left superior vena cava was divided from the left atrial junction, passed through under the ascending aorta and anastomosed to the right superior vena cava., Conclusion: To our knowledge, this is the first patient reported with persistent left superior vena cava, unroofed coronary sinus, coronary sinus orifice atresia, and tetralogy of Fallot. The extracardiac direct anastomosis technique was used successfully to direct persistent left superior vena cava to the right atrium without any post-procedure complications.
- Published
- 2023
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32. Bilateral inferior venae cava combined with the persistent left superior vena cava and hemiazygos continuation of left inferior vena cava with drainage into right atrium: A case report.
- Author
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Jia Y and Gao J
- Subjects
- Infant, Newborn, Female, Humans, Vena Cava, Inferior diagnostic imaging, Vena Cava, Inferior abnormalities, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior abnormalities, Heart Atria diagnostic imaging, Drainage, Persistent Left Superior Vena Cava, Vascular Malformations complications, Vascular Malformations diagnostic imaging, Heterotaxy Syndrome
- Abstract
The persistent left superior vena cava (PLSVC) is a common venous abnormality. However, malformation of the bilateral inferior venae cava (IVC) is extremely rare, with an incidence rate of .3%. IVC malformation is associated most frequently with heart defects and isomerism and often has a poor prognosis. We presented a case of vascular malformations in the fetus of bilateral caval veins with the interruption of the left-sided venous return with hemiazygos continuation in presence of a right-sided inferior caval vein. Also noted were the PLSVC and a dilated right heart with a widened pulmonary trunk. In this case, there were no heart defects or chromosomal abnormalities, and the newborn postpartum was in a good condition., (© 2023 Wiley Periodicals LLC.)
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- 2023
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33. Analysis of six cancer patients with persistent left superior vena cava identified during central venous access device placement via an intracavitary electrocardiogram.
- Author
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Wang X, Yang Y, Dong J, Wang X, Zheng Y, Chen J, Shen Y, and Wang H
- Subjects
- Humans, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior abnormalities, Electrocardiography, Persistent Left Superior Vena Cava, Catheterization, Peripheral, Neoplasms complications, Neoplasms diagnosis, Catheterization, Central Venous
- Abstract
Persistent left superior vena cava (PLSVC) is a rare congenital anomaly. PLSVC can be associated with clinically significant atrial septal defect (ASD) or ventricular septal defect (VSD). It is usually asymptomatic and accidentally detected during invasive procedures or imaging examinations. However, whether central venous access device (CVAD) can be placed and used in patients with PLSVC is controversial. A total of six patients were diagnosed with PLSVC and confirmed by chest CT among 3391 cancer patients who underwent CVAD placement via intracavitary electrocardiogram (IC-EKG) at the Venous Access Center (VAC) from May 2019 to December 2020. The CVADs (peripherally inserted central catheter in four patients and Ports in two patients) of these six patients were left in PLSVC. We analyzed changes in the P-wave in the IC-EKG during CVAD placement and the characteristics of the body surface electrocardiogram in these patients and discussed the catheter tip position in PLSVC. All six patients showed negative P-waves in lead II via IC-EKG from the beginning of catheterization: four patients showed negative P-waves and two showed biphasic P-waves in the body surface electrocardiogram (lead III) before catheterization. CVAD function was normal and no obvious complications were observed during the treatment of these patients. The total retention time of CVADs was 1537 days. For patients with a negative P-wave in lead II via IC-EKG during catheterization, especially in those with a negative or biphasic P-wave in lead III of the body surface electrocardiogram, PLSVC should be considered. CVAD insertion in patients with type I PLSVC is safe under certain conditions, with the proper tip position in the middle to lower part of PLSVC., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2023
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34. Modification of the Warden Procedure for Surgical Repair of Partial Anomalous Pulmonary Venous Connection.
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Danton MHD and Kesieme EB
- Subjects
- Humans, Vena Cava, Superior surgery, Vena Cava, Superior abnormalities, Heart Atria surgery, Pulmonary Veins surgery, Pulmonary Veins abnormalities, Heart Septal Defects, Atrial surgery, Scimitar Syndrome diagnostic imaging, Scimitar Syndrome surgery
- Abstract
Warden procedure is a popular technique for repairing partial anomalous pulmonary venous connection. We describe a modification of this technique for surgical repair of this condition by raising both a superior vena cava (SVC) flap and right atrial appendage flap to create a tension-free SVC-RA continuity (neo-SVC). The anomalous pulmonary veins are routed via the remanent of proximal SVC and baffled to the left atrium across a surgically created or enlarged atrial septal defect using autologous pericardium.
- Published
- 2023
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35. Partial Anomalous Pulmonary Venous Connection With Intact Atrial Septum: Early and Midterm Outcomes.
- Author
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Graham G, Dearani JA, Mathew J, Miranda WR, King KS, Schaff HV, and Stephens EH
- Subjects
- Humans, Adult, Vena Cava, Superior surgery, Vena Cava, Superior abnormalities, Heart Atria surgery, Atrial Septum, Scimitar Syndrome surgery, Heart Septal Defects, Atrial surgery, Pulmonary Veins surgery, Pulmonary Veins abnormalities
- Abstract
Background: Partial anomalous pulmonary venous return with intact atrial septum warrants greater understanding and evaluation in the literature., Methods: From January 1993 to December 2018, 293 patients with partial anomalous pulmonary venous return underwent surgical repair. Of these, 45 patients (15.3%) had an intact atrial septum. The median age was 36 years (interquartile range, 24-48). Direct reimplantation was used in 17 patients (38%), intracardiac baffling in 15 (33%), and caval division (Warden) technique in 13 (29%). Descriptive statistics were used to assess the data, and Kaplan-Meier analysis was used to assess survival., Results: Anomalous veins were right-sided in 27 patients (60%), left-sided in 16 patients (36%), and bilateral in 2 patients (4%). The insertion sites were the superior vena cava in 23 patients (51%), innominate vein in 12 (27%), inferior vena cava in 6 (13%), coronary sinus in 2 (4%), right atrium in 1 patient (2%), and unknown in 1 patient (2%). Scimitar syndrome was noted in 8 patients (18%). There was no postoperative mortality or residual defects. Postoperative echocardiography excluded any obstruction of pulmonary or systemic veins. Postoperative complications included atrial fibrillation in 9 patients (20%) and pneumothorax requiring chest tube in 5 patients (11%). Survival at 1, 5, and 10 years was 100%, 95%, and 95%, respectively. Two patients underwent pulmonary vein dilation, one at 3 years and the other at 7 years., Conclusions: Surgical repair of partial anomalous pulmonary venous connection with intact atrial septum can be performed with excellent early and midterm outcomes. The overall incidence of midterm systemic or pulmonary vein stenosis is low., (Copyright © 2023 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
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36. Modified Warden Procedure for Partial Anomalous Pulmonary Venous Drainage to Promote Growth.
- Author
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Kadowaki S, Saprungruang A, Dragulescu A, Yoo SJ, and Haller C
- Subjects
- Humans, Vena Cava, Superior surgery, Vena Cava, Superior abnormalities, Follow-Up Studies, Drainage, Scimitar Syndrome surgery, Pulmonary Veins surgery, Pulmonary Veins abnormalities
- Abstract
Extreme forms of partially anomalous pulmonary venous drainage with high entrance of the pulmonary veins into the superior caval vein can be challenging to correct without obstructing both systemic and pulmonary venous pathways. We report an unusual morphologic subform of this malformation and a surgical technique to address its specific anatomic peculiarities while maintaining growth potential of the venous pathways. We highlight that even such complex reconstructions can be performed minimally invasively., (Copyright © 2023 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
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37. Long-Term Surgical Outcomes of Patients With Isomeric Right and Left Atrial Appendages.
- Author
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Chowdhury UK, Anderson RH, Pandey NN, George N, Sankhyan LK, Khan MA, Goja S, Ramakrishnan S, and Gupta SK
- Subjects
- Humans, Infant, Newborn, Vena Cava, Superior abnormalities, Isomerism, Treatment Outcome, Heart Atria surgery, Atrial Appendage diagnostic imaging, Atrial Appendage surgery, Atrial Appendage abnormalities, Univentricular Heart, Pulmonary Veins abnormalities, Heart Defects, Congenital surgery, Heterotaxy Syndrome diagnostic imaging, Heterotaxy Syndrome surgery
- Abstract
Objectives: To compare the long-term outcomes of biventricular, univentricular, and so-called one-and-one-half ventricular repairs in patients with left and right isomerism. Methods: Surgical correction was undertaken, between 2000 and 2021, in 198 patients with right, and 233 with left isomerism. Results: The median age at operation was 24 days (interquartile range [IQR]: 18-45) and 60 days (IQR: 29-360) for those with right and left isomerism, respectively. Multidetector computed-tomographic angiocardiography demonstrated more than half of those with right isomerism had superior caval venous abnormalities, and one-third had a functionally univentricular heart. Almost four-fifths of those with left isomerism had an interrupted inferior caval vein, and one-third had complete atrioventricular septal defect. Biventricular repair was achieved in two-thirds of those with left isomerism, but under one-quarter with right isomerism ( P < .001). Hazard regression for mortality revealed odds for prematurity at 5.5, pulmonary atresia at 2.81, atrioventricular septal defect with a common valvar orifice at 2.28, parachute mitral valve at 3.73, interrupted inferior caval vein at 0.53, and functionally univentricular heart with a totally anomalous pulmonary venous connection at 3.77. At a median follow-up of 124 months, the probability of survival was 87% for those with left, and 77% for those with right isomerism ( P = .006). Conclusions: Multimodality imaging characterizes and delineates the relevant anatomical details, facilitating surgical management of individuals with isomeric atrial appendages. Continuing higher mortality despite surgical intervention in those with right isomerism points to the need for the reassessment of strategies for management.
- Published
- 2023
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38. Computed tomography and magnetic resonance imaging of congenital thoracic systemic venous anomalies.
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Batouty NM, Tawfik AM, Sobh DM, and Razek AAKA
- Subjects
- Humans, Vena Cava, Superior abnormalities, Vena Cava, Inferior abnormalities, Magnetic Resonance Imaging, Tomography, X-Ray Computed, Heterotaxy Syndrome diagnostic imaging, Vascular Malformations diagnostic imaging
- Abstract
We present the imaging findings of thoracic systemic venous anomalies diagnosed by computed tomography and magnetic resonance imaging. Persistent left superior vena cava is the commonest anomaly of the thoracic systemic veins encountered either incidentally as an isolated finding or associated with congenital heart disease. Inferior vena cava (IVC) interruption with azygos continuation is the second most common anomaly, which may also be isolated or be associated with left isomerism syndrome. The article will also discuss other rarer systemic venous anomalies including retroaortic brachiocephalic vein and IVC drainage into the left atrium. Finally, the impact of pre-procedure reporting of thoracic systemic venous anomalies on the choice of intervention and patient outcome will be addressed., (© 2023. The Author(s).)
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- 2023
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39. Infradiaphragmatic partial anomalous pulmonary venous connection in adulthood. Considerations for management: a single centre experience.
- Author
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Cavalla F, Nuri HA, Pomè G, and Cipriani A
- Subjects
- Adult, Humans, Vena Cava, Superior abnormalities, Anticoagulants, Pulmonary Veins abnormalities, Atrial Fibrillation, Scimitar Syndrome surgery
- Abstract
Background and Objectives: Infradiaphragmatic partial anomalous pulmonary venous connection is occasionally diagnosed in adulthood. Management of infradiaphragmatic PAPVC depends on anatomy and clinical presentation., Methods: Over a 10-year period, we observed seven adult patients (median age 29 years) with partial anomalous pulmonary venous connection. We classified our patients in two groups. Group I: isolated partial anomalous pulmonary venous connection from one pulmonary lobe to the inferior vena cava, three patients. Group II: partial anomalous pulmonary venous connection of the entire right lung to IVC, four patients., Results: The mean term follow-up was 5.4 years. Patients in Group I have been managed conservatively, as they were asymptomatic, without a significant shunt. Patients in Group II were surgically corrected using long right intra-atrial baffles. After 6 months of follow-up, the first two cases were diagnosed with complete tunnel thrombosis and loss of right lung function. Oral anticoagulation failed to recanalize the tunnel. Considering this serious complication, the other two patients were empirically and preventively treated with anticoagulation after surgery, with good outcome on long-term follow-up., Conclusions: Conservative management should be considered for asymptomatic patients, without a significant shunt. Surgical treatment of infradiaphragmatic partial anomalous pulmonary venous connection of the entire right lung in inferior vena cava is challenging. Slow blood flow inside the long intra-atrial baffles inclines to thrombosis and occlusion, as we observed in two cases. Therefore, oral anticoagulation should be considered for long baffles with slow blood flow.
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- 2023
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40. Echocardiographic evaluation of supracardiac anomalous pulmonary venous connection in children: comparison with multilayer spiral CT.
- Author
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Zhao N, Hu Y, Tuo S, Zhou J, Zhang S, Liu L, and Meng X
- Subjects
- Humans, Child, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior abnormalities, Predictive Value of Tests, Tomography, Spiral Computed, Echocardiography methods, Scimitar Syndrome diagnostic imaging, Pulmonary Veins diagnostic imaging, Pulmonary Veins surgery, Pulmonary Veins abnormalities
- Abstract
Objective To explore the clinical value of transthoracic echocardiography (TTE) in the differentiation of Supracardiac Anomalous Pulmonary Venous Connection (SAPVC) in children. Materials and methods A total of 118 children with concurrent TTE and CT databases of cases diagnosed with SAPVCs were included. We analyzed the consistency between the two for the ability to diagnose the classification of SAPVC, drainage sites, ectopic pulmonary veins and the segments of superior vena cava (SVC). Results The consistency between TTE and CT in diagnosing the existence of SAPVC and the classification were 88.1% (95% CI: 80.9-93.4%) and 91.0% (95% CI: 84.1-95.6%), respectively. The error rate of partial type diagnosed by TTE was significantly higher than that of total and mixed type (20.5% vs. 2.8%, P = 0.003). The consistency between TTE and CT to determine drainage sites was 91.9% (95% CI: 85.2-96.2%). TTE had a significantly higher error rate in determining pulmonary vein drainage to the SVC than in those draining into the left innominate vein (17.5 vs. 2.5%, P = 0.007). The consistency of TTE and CT in judging the number of veins was 87.4% (95% CI: 79.7-92.9%). The error rate in determining the presence of 2 and 5 ectopic pulmonary veins was significantly higher than those of 1 and 4 veins (P < 0.05). Conclusion TTE for diagnosing partial SAPVC and identifying the drainage site of SVC has a high error rate of misdiagnosis and missed diagnosis. The extra attention should be given to these factors in clinical practice to improve the accuracy of TTE in diagnosing SAPVC., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)
- Published
- 2023
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41. Heart Transplant Using a Donor Heart With Only a Persistent Left Superior Vena Cava: A Case Report.
- Author
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An C, Kindzelski BA, Tong MZY, Soltesz EG, and Weiss AJ
- Subjects
- Humans, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior surgery, Vena Cava, Superior abnormalities, Tissue Donors, Persistent Left Superior Vena Cava, Heart Transplantation, Atrial Fibrillation
- Abstract
A persistent left superior vena cava (PLSVC) is a congenital anomaly wherein the left superior cardinal vein fails to regress. We describe the case of a successful orthotopic heart transplant using a donor heart with a PLSVC and congenital absence of a right superior vena cava (SVC) in a recipient with normal anatomy. After donor cardiectomy, the donor organ's PLSVC was ligated near the insertion site into the coronary sinus. The recipient underwent cardiectomy such that the native SVC was left with a long right atrial cuff. A modified bicaval technique was used to anastomose the recipient's right atrial cuff directly to the donor's right atrial appendage. This technique restored the recipient's normal anatomy, and we demonstrated that donor hearts with a PLSVC and absent right SVC might be used for transplant. Without other disqualifying abnormalities, surgeons should consider accepting these organs for life-saving transplant operations., Competing Interests: DISCLOSURES The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)
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- 2023
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42. Left main coronary artery aneurysm with fistula to superior vena cava: A challenging case.
- Author
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Pujara J, Panda S, Singh G, Harbola G, Sachan P, Chhauda T, and Vachaparampil R
- Subjects
- Male, Humans, Adult, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior abnormalities, Coronary Vessels diagnostic imaging, Coronary Vessels surgery, Echocardiography methods, Coronary Angiography, Coronary Aneurysm complications, Coronary Aneurysm diagnostic imaging, Coronary Aneurysm surgery, Fistula, Heart Defects, Congenital, Coronary Vessel Anomalies complications, Coronary Vessel Anomalies diagnostic imaging, Coronary Vessel Anomalies surgery
- Abstract
Coronary artery fistulas (CAFs) are rare congenital coronary artery abnormalities, with direct communication between a coronary artery and a cardiac chamber, great vessel or other structure. We report here, a rare case of a 25-year-old male with CAF from the aneurysmal left main coronary artery to the superior vena cava detected on echocardiography and computerized tomography (CT) coronary angiography.
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- 2023
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43. Coronary Sinus Defect, Premature Restriction of Foramen Ovale and Cysto-Colic Peritoneal Band.
- Author
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Jaiman S
- Subjects
- Humans, Vena Cava, Superior abnormalities, Coronary Sinus abnormalities, Foramen Ovale, Colic, Heart Defects, Congenital, Hypoplastic Left Heart Syndrome
- Abstract
Background : Unroofed coronary sinus is a congenital cardiac anomaly usually associated with persistent left superior vena cava. Premature restriction or closure of foramen ovale is described in association with hypoplastic left heart syndrome. Abdominal peritoneal bands when present manifest clinically. Case report: A 27 years, gravida 2, presented with intrauterine fetal death at 24 weeks gestation due to fetal congestive cardiac failure, cardiomegaly and hydrops. Perinatal autopsy showed absent coronary sinus with cardiac veins draining directly into the heart. There was no persistent left superior vena cava. The foramen ovale was restricted prematurely. The ductus arteriosus was present and non-restrictive. Abdomen showed a cysto-colic peritoneal band. Conclusion : This is the first report showing a triad of (1) complete absence of coronary sinus without left superior vena cava (type-II); (2) premature restriction of foramen ovale without hypoplastic left heart; and (3) a cysto-colic peritoneal band between the gall bladder and colon.
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- 2023
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44. Multiple accessory pathways coexisting with a persistent left superior vena cava: a case report.
- Author
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Uemura T, Kondo H, Shinohara T, Takahashi M, Akamine K, Ogawa N, Hirota K, Fukui A, Akioka H, Yufu K, and Takahashi N
- Subjects
- Male, Humans, Middle Aged, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior abnormalities, Electrocardiography, Echocardiography adverse effects, Wolff-Parkinson-White Syndrome complications, Wolff-Parkinson-White Syndrome surgery, Persistent Left Superior Vena Cava complications
- Abstract
Background: Wolff-Parkinson-White syndrome is characterized by a short PR interval (delta-wave), long QRS complex, and the appearance of paroxysmal supraventricular tachycardia. Patients with Wolff-Parkinson-White syndrome usually have one accessory pathway, whereas cases with multiple accessory pathways are rare. Persistent left superior vena cava is a vascular anomaly in which the vein drains into the right atrium through the coronary sinus at the junction of the left internal jugular and subclavian veins due to abnormal development of the left cardinal vein. The simultaneous presence of multiple accessory pathways and persistent left superior vena cava has not been reported before., Case Presentation: A 56-year-old Japanese man with a 5-year history of palpitations was referred for radiofrequency catheter ablation due to increased frequency of tachycardia episodes in the previous 2 months. Persistent left superior vena cava was confirmed by transthoracic echocardiography and computed tomography. An electrophysiological study revealed that the accessory pathways were located in the left lateral wall, anterolateral wall, and posteroseptal region. They were completely ablated with radiofrequency energy application., Conclusions: We reported an extremely rare case of a patient with multiple accessory pathways and persistent left superior vena cava. Our case may suggest a potential embryological relationship between the multiple accessory pathways and persistent left superior vena cava., (© 2023. The Author(s).)
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- 2023
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45. Repair of Partial Anomalous Pulmonary Venous Connection to the Azygous Vein via Right Thoracotomy.
- Author
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Said SM, Ricciardi G, Smith BJ, Sainathan S, and Narasimhan SL
- Subjects
- Male, Humans, Infant, Vena Cava, Superior surgery, Vena Cava, Superior abnormalities, Thoracotomy, Azygos Vein surgery, Scimitar Syndrome diagnostic imaging, Scimitar Syndrome surgery, Pulmonary Veins surgery, Pulmonary Veins abnormalities
- Abstract
A 21-month-old boy was diagnosed with partial anomalous pulmonary venous connection, with the right upper pulmonary veins draining to the superior vena cava (SVC). Intraoperatively, it became evident that the right upper pulmonary veins connected to the azygous vein before draining to the SVC.
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- 2023
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46. A black box congenital heart defect: Anomalous superior vena cava drainage into the left atrium.
- Author
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Karev E, Karpova D, Stovpyuk O, and Kozlenok A
- Subjects
- Female, Pregnancy, Humans, Adult, Heart Atria diagnostic imaging, Heart Atria abnormalities, Angiography, Drainage, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior abnormalities, Heart Defects, Congenital complications, Heart Defects, Congenital diagnostic imaging, Heart Defects, Congenital surgery
- Abstract
A 25-year-old pregnant woman with low oxygen saturation due to unclear congenital heart disease was admitted. During work-up the rare anomaly of superior vena cava drainage to the left atrium was diagnosed by transthoracic bubble test with agitated saline. The pathology was later confirmed by contrast multislice computed tomography angiography after delivery., (© 2022 Wiley Periodicals LLC.)
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- 2023
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47. Long-term results of the Warden procedure for right partial anomalous pulmonary venous connection.
- Author
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Dubost C, Pavy C, Maminirina P, Benbrik N, and Baron O
- Subjects
- Adolescent, Humans, Constriction, Pathologic, Follow-Up Studies, Treatment Outcome, Vena Cava, Superior abnormalities, Infant, Child, Preschool, Child, Young Adult, Adult, Middle Aged, Aged, Pulmonary Veins surgery, Pulmonary Veins abnormalities, Scimitar Syndrome surgery
- Abstract
Introduction: Surgery is considered as the first-line therapeutic strategy of partial anomalous pulmonary venous connection. The Warden technique has very good short-term results. The aim of this study is to evaluate the stability of these good results over a long period of follow-up., Materials and Methods: We reviewed all patients who underwent a Warden procedure for partial anomalous pulmonary venous connection between 1997 and 2017 in our centre. A total of 73 patients were included. The median age was 14 years (5 months-72 years). Post-operative data were obtained through our hospital network. Late follow-up data were obtained through referrals, cardiologist letters and directly from the patient., Results: The mean length of follow-up was 8 years and the longest time was 22 years (range, 1-22). Twenty-five percent of our cohort had more than 10 years of follow-up. There were no cardio-vascular deaths. Eight (11.6%) patients suffered from post-operative rhythm disturbances, 5 (7.2%) of which were permanent. Two (2.9%) patients required a pacemaker implantation. At the end of the follow-up period, only one patient remained pacemaker dependent. There were no pulmonary vein obstructions. Two (2.9%) caval vein stenosis were detected, one at 7 months and the other at 7 years. These patients were treated by angioplasty alone. Five (6.8%) patients were lost to follow-up., Conclusions: The good short-term results of the Warden procedure for right partial anomalous pulmonary venous connection appear to persist in the long term, with excellent freedom from pulmonary and caval stenosis in adolescence through to adulthood.
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- 2023
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48. Coronary anomalies associated with ventricular septal defect.
- Author
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Kobayashi M, Muneuchi J, Sugitani Y, Yamada A, Ezaki H, and Watanabe M
- Subjects
- Humans, Vena Cava, Superior abnormalities, Retrospective Studies, Bicuspid Aortic Valve Disease complications, Coronary Vessel Anomalies diagnostic imaging, Coronary Vessel Anomalies epidemiology, Coronary Vessel Anomalies complications, Heart Septal Defects, Ventricular diagnostic imaging, Heart Septal Defects, Ventricular epidemiology
- Abstract
Coronary anomalies encompass different conditions in terms of anomalous origin, coursing, and branching, which are occasionally associated with congenital heart disease. This study aimed to explore coronary anomalies associated with ventricular septal defect that was a stereotypical congenital heart disease. We retrospectively reviewed angiographic findings in patients with ventricular septal defect who required corrective surgery, and identified coronary abnormalities, including anomalous origin, coursing, and branching of coronary arteries based on angiography. We studied the prevalence and types of coronary anomalies among them. A total of 998 patients with ventricular septal defect was studied. Age and weight were 2.0 (2.1-15.2) months and 5.7 (4.1-8.7) kg, respectively. There were 115 patients (12%) with syndrome or genetic disorder, and 34 patients (3%) with extracardiac major organ anomalies. The overall prevalence of coronary anomalies was 6.2%. All coronary anomalies were anomalous origin and coursing, among 3 patients accompanied anomalous intrinsic coronary anatomy. Originating within aortic root above the Valsalva sinus was the most common coronary anomaly. Coronary anomalies were independently correlated with bicuspid aortic valve (odds ratio [OR]: 8.02, 95% confidence interval [CI]: 2.34-23.4) and persistent left superior caval vein (OR: 5.02, 95% CI: 1.93-11.7). We showed the possibility that minor cardiac variants, such as bicuspid aortic valve and persistent left superior caval vein, contribute to higher prevalence of coronary anomalies in patients with ventricular septal defect., (© 2022. Springer Japan KK, part of Springer Nature.)
- Published
- 2023
- Full Text
- View/download PDF
49. Persistent Left Superior Vena Cava and Inferior Vena Cava Dual Drainage to Coronary Sinus: A Case Report.
- Author
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Pitt S, Chen J, White AM, and Lizano Santamaria RW
- Subjects
- Infant, Humans, Vena Cava, Inferior diagnostic imaging, Vena Cava, Inferior abnormalities, Vena Cava, Superior diagnostic imaging, Vena Cava, Superior abnormalities, Drainage, Persistent Left Superior Vena Cava, Coronary Sinus diagnostic imaging, Heart Defects, Congenital diagnostic imaging, Heart Defects, Congenital surgery, Vascular Malformations diagnostic imaging, Vascular Malformations surgery
- Abstract
Dilation of the coronary sinus is often a result of excessive volume overload from congenital anomalies of systemic venous return to the heart. These abnormalities are often discovered incidentally later in life when a patient requires cardiac imaging, cardiac catheterization, or thoracic surgery. The most common abnormality is a persistent left superior vena cava. Inferior vena cava malformation is less common, yet several different anomalies can arise. The presence of persistent left superior vena cava or inferior vena cava anomalies requires further evaluation to rule out congenital heart disease in infants. Knowledge of technically challenging systemic venous anatomy is beneficial prior to procedures necessitating central venous access such as a central line, cardiac catheterization, and intracardiac device implantation. We present an unusual case of persistent LSVC and IVC both draining directly into a severely dilated coronary sinus that was diagnosed by fetal echocardiogram and later confirmed postnatally by transthoracic echocardiogram and computed tomography angiography. To our knowledge this is the second reported case of IVC drainage into the CS and the first case that reports this as a prenatal diagnosis., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Published
- 2023
- Full Text
- View/download PDF
50. Primary sutureless repair concomitant with the Warden procedure.
- Author
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Watanabe S, Nakata T, Suehiro S, Yasuda K, Nakashima S, and Oda T
- Subjects
- Female, Humans, Infant, Vena Cava, Superior abnormalities, Tomography, X-Ray Computed, Sutureless Surgical Procedures, Pulmonary Veins surgery, Scimitar Syndrome complications, Scimitar Syndrome diagnostic imaging, Scimitar Syndrome surgery
- Abstract
A 2-month-old girl who had supracardiac total anomalous pulmonary venous connection (Darling classification type 1b) was referred to our institution. Computed tomography showed that multiple right upper pulmonary veins drained into the vertical vein, near the entry to the superior vena cava. The common pulmonary venous chamber was located lower right than usual, and right upper pulmonary veins were far from the common chamber. We successfully performed primary sutureless repair concomitant with the Warden procedure. Postoperative computed tomography showed unobstructed pulmonary veins and superior vena cava routes, and the vertical vein between right upper and lower pulmonary veins shrank slightly.
- Published
- 2023
- Full Text
- View/download PDF
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