Mitral and Aortic Atresia Associated with Hypoplastic Right Lung, Crossover Segment of Right Lower Lobe, and Anomalous Scimitar-like Right Pulmonary Venous Connection with Inferior Vena Cava: Clinical, Angiocardiographic, and Autopsy Findings in a Rare Case

A newborn female infant was found to have a unique and previously unreported group of anomalies: ( 1) mitral and aortic atresia with a highly obstructive atrial septum; ( 2) hypoplasia of the right lung with a crossover segment involving the right lower lobe; ( 3) normally connected pulmonary veins, two from the left lung and one from the right; and ( 4) a large anomalous branch of the right pulmonary vein of scimitar configuration that anastomosed with the normally connected right pulmonary vein and with the inferior vena cava (IVC). The scimitar vein appeared obstructed at its junction with the right pulmonary vein and at its junction with the inferior vena cava within the hepatic parenchyma. To our knowledge, this is the first report of a scimitar-like vein coexisting with mitral and aortic atresia and connecting both with the right pulmonary vein and with the inferior vena cava. The highly obstructed left atrium was partially decompressed by retrograde blood flow via the normally connected right pulmonary vein to the anomalous scimitar venous pathway and thence to the inferior vena cava via a pulmonary-to-IVC collateral vein.

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A Particular Infantile Scimitar Syndrome Variant with Anomalous Systemic Arterial Supply-Inferior Vena Cava Fistula

Journal Of Cardiovascular Emergencies ◽

10.2478/jce-2021-0002 ◽

2021 ◽

Vol 7 (1) ◽

pp. 17-21

Author(s):

Carmen Corina Șuteu ◽

Cristina Blesneac ◽

Marian Pop ◽

Amalia Făgărășan ◽

Liliana Gozar ◽

...

Keyword(s):

Inferior Vena Cava ◽

Abdominal Aorta ◽

Inferior Vena ◽

Pulmonary Hypoplasia ◽

Pulmonary Veins ◽

Vena Cava ◽

Scimitar Syndrome ◽

Cardiovascular Malformation ◽

The Right ◽

Systemic Arterial Supply

Abstract Scimitar syndrome is a rare congenital cardiovascular malformation that includes a partially anomalous drainage of the pulmonary veins in the inferior vena cava, right pulmonary hypoplasia, and systemic-pulmonary collaterals originating from various segments of the aorta. We present a case of Scimitar syndrome with associated intracardiac lesions and a large arterial conduct supplying the right lung, originating from the abdominal aorta and draining in the inferior vena cava.

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PARTICULARITIES OF SCIMITAR SYNDROME IN ADULT PATIENTS

International Journal of Advanced Research ◽

10.21474/ijar01/12967 ◽

2021 ◽

Vol 9 (5) ◽

pp. 1274-1278

Author(s):

Soumia Faid ◽

◽

Amine Maliki Alaoui ◽

Nadif Maryam ◽

Liban Ibrahim ◽

...

Keyword(s):

Inferior Vena Cava ◽

Right Atrium ◽

Inferior Vena ◽

Superior Vena ◽

Pulmonary Veins ◽

Vena Cava ◽

Venous Drainage ◽

Scimitar Syndrome ◽

Chest X Ray ◽

The Right

Scimitar syndrome or Felsons veno-lobar syndrome is a very rare congenital disease characterized by a combination of cardiopulmonary abnormalities, including partial right-sided pulmonary venous drainage to the inferior vena cava, the inferior cavo-atrial junction, or low on the right atrium. We report the case of a 53-year-old female patient who presented with recent gradually worsening dyspnea. The diagnosis was suspected on the chest x-ray and confirmed on Cardiac echography andComputed Tomography scan that showed a wide collector gathering the three right superior pulmonary veins that joins the lower part of the superior vena cava, thus joining the right atrium while the right inferior pulmonary vein is drained into the inferior vena cava. The patient was treated surgically by performing a derivation of the right superior pulmonary venous collector to the left atrium with a tricuspid annuloplasty with a good outcome.

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A case report of pulmonary vein isolation performed in a patient with polysplenia and interrupted inferior vena cava

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytab480 ◽

2021 ◽

Author(s):

Kaspars Kupics ◽

Kristine Jubele ◽

Georgijs Nesterovics ◽

Andrejs Erglis

Keyword(s):

Inferior Vena Cava ◽

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Inferior Vena ◽

Femoral Vein ◽

Pulmonary Veins ◽

Vena Cava ◽

Venous Access ◽

University Hospital ◽

Anatomical Variant

Abstract Background Pulmonary vein isolation (PVI) has entrenched itself as one of main approaches for treatment of paroxysmal symptomatic atrial fibrillation (AF). PVI prevents focal triggers from pulmonary veins from initiating AF paroxysms. As standard—PVI is performed through the inferior vena cava (IVC) approach, through the femoral vein. However, there are conditions when this approach is not appropriate or is not available. Case summary We report a case of a 53-year-old male who was referred to Pauls Stradins Clinical University Hospital for PVI due to worsening AF. Due to the rare anatomical variant of the venous system the standard approach to PVI could not be applied. Interrupted cava inferior did not allow for femoral vein and IVC access. We had to figure out a different path—a combination of internal jugular and subclavian veins was used. Transseptal puncture was performed under transesophageal echocardiography (TOE) control with a puncture needle stiletto. Pulmonary veins were isolated successfully, no complications were observed, and the patient was discharged in sinus rhythm. Discussion In some patients PVI cannot be done through the standard IVC approach. In such cases a different venous access must be chosen. Our patient had a rare variant of interrupted IVC and we had to use superior vena cava approach for the procedure. The difficulty of this approach is that procedure instruments are not designed for non-standard venous access, however a combined use of TOE, general anaesthesia and contact force guided ablation has succeeded in isolating patients’ pulmonary veins.

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Isolated Left-sided Scimitar Vein Connecting All Left Pulmonary Veins to the Right Inferior Vena Cava

Pediatric Cardiology ◽

10.1007/s00246-005-0920-9 ◽

2005 ◽

Vol 26 (6) ◽

pp. 846-847 ◽

Cited By ~ 14

Author(s):

A.L. Juraszek ◽

H. Cohn ◽

R. Van Praagh ◽

S. Van Praagh

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Pulmonary Veins ◽

Vena Cava ◽

The Right

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Ultrasound Diagnosis of Congestion in the Pulmonary and Systemic Circulations in Patients with Atrial Fibrillation and Chronic Heart Failure

10.21203/rs.3.rs-390567/v1 ◽

2021 ◽

Author(s):

Venera Kirillova ◽

Andrey Smorgon ◽

Alla Garganeeva ◽

Roman Batalov ◽

Viktor Meshchaninov ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Chronic Heart Failure ◽

Inferior Vena Cava ◽

Pulmonary Vein ◽

Inferior Vena ◽

Vena Cava ◽

Average Pressure ◽

Superior Pulmonary Vein ◽

The Right

Abstract BackgroundFluid retention is one of the most common reasons for the heart failure decompensation. The purpose of the study is to estimate the sensitivity, specificity of the ultrasound method for evaluating congestive phenomena in the systemic and pulmonary circulations in patients with the atrial fibrillation (AF) and chronic heart failure (CHF).MethodsThe study includes 28 patients with the paroxysmal AF with and without CHF, who were planned for the radiofrequency pulmonary veins isolation. The maximum and minimum diameters of the right superior pulmonary vein and inferior vena cava on exhalation were measured echocardiographically. An average pressure in the right and left atria was measured intraoperatively. Сorrelation between the maximum and minimum diameters of the right superior pulmonary vein and an average pressure in the left atria and between inferior vena cava on exhalation and an average pressure in the right atria was calculated. The sensitivity, specificity of ultrasound methods for evaluating congestive phenomena in the systemic and pulmonary circulations was evaluated.ResultsThere was positive correlation between the minimum diameter of right superior pulmonary vein and invasive mean pressure in the left atrium (R=0.65, P<0.05), between invasive measured mean pressure in the right atrium and the diameter of the inferior vena cava on exhalation (R=0.49, P<0.05). Sensitivity of the method – maximum diameters of the right superior pulmonary vein greater than 21.7 mm are ultrasound criteria for venous pulmonary hypertension is 75%, specificity – 86%. Sensitivity of the method minimum diameters of the right superior pulmonary vein greater than 10.5 mm are ultrasound criteria for venous pulmonary hypertension is 85%, specificity – 86%. The sensitivity of the inferior vena cava diameter exceeding 18,5 mm on exhalation is 100%, the specificity is 92%.ConclusionsThe new ultrasound method of congestion diagnostics in the pulmonary circulation by the maximum and/or minimum diameter of the right superior pulmonary vein can be effectively applied in clinical practice in the same way as the well-known technique of congestion diagnostics in the systemic circulation by the diameter of the inferior vena cava in patients with the atrial fibrillation and chronic heart failure.

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Emphysematous pyelonephritis with air bubble in the inferior vena cava

African Journal of Urology ◽

10.1186/s12301-020-00081-2 ◽

2020 ◽

Vol 26 (1) ◽

Author(s):

Tiffany A. Perkins ◽

Alberic Rogman ◽

Murali K. Ankem

Keyword(s):

Septic Shock ◽

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Rare Presentation ◽

Emphysematous Pyelonephritis ◽

Case Presentation ◽

Air Bubble ◽

First Case ◽

The Right

Abstract Background Emphysematous pyelonephritis (EPN) with gas in the inferior vena cava (IVC) is a rare presentation and to our knowledge, this is the first case report in the urologic literature. Case presentation A 35-Year-old obese diabetic Hispanic female presented to the emergency room with a clinical picture of septic shock. Prompt computerized tomography scan revealed EPN with gas throughout the right renal parenchyma and extending to the right renal vein, IVC, and pulmonary artery. She died before surgical intervention Conclusion This case demonstrates that patients presenting with severe EPN have a high mortality risk and providers should acknowledge that septic shock, endogenous air emboli, or a combination of both could result in cardiovascular collapse and sudden death.

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Recanalization and Reconstruction of a Chronically Occluded Inferior Vena Cava Through an Existing Transjugular Intrahepatic Portosystemic Shunt in the Setting of Budd-Chiari Syndrome

Vascular and Endovascular Surgery ◽

10.1177/15385744211002026 ◽

2021 ◽

pp. 153857442110020

Author(s):

Reza Talaie ◽

Hamed Jalaeian ◽

Nassir Rostambeigi ◽

Anthony Spano ◽

Jafar Golzarian

Keyword(s):

Inferior Vena Cava ◽

Transjugular Intrahepatic Portosystemic Shunt ◽

Inferior Vena ◽

Vena Cava ◽

Portosystemic Shunt ◽

Hepatic Veins ◽

Budd Chiari Syndrome ◽

Chiari Syndrome ◽

Intrahepatic Portosystemic Shunt ◽

The Right

Budd-Chiari syndrome (BCS) results from the occlusion or flow reduction in the hepatic veins or inferior vena cava and can be treated with transjugular intrahepatic portosystemic shunt when hepatic vein recanalization fails.1-3 Hypercoagulable patients with primary BCS are predisposed to development of new areas of thrombosis within the TIPS shunt or IVC. This case details a patient with BCS, pre-existing TIPS extending to the right atrium, and chronic retrohepatic IVC thrombosis who underwent sharp recanalization of the IVC with stenting into the TIPS stent bridging the patient until his subsequent hepatic transplantation.

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Stent Graft Placement in the Top-Down Direction for Treating Traumatic Intra-Abdominal Suprahepatic Inferior Vena Cava Rupture: A Case Report

Journal of Endovascular Therapy ◽

10.1177/15266028211025024 ◽

2021 ◽

pp. 152660282110250

Author(s):

Yun Chul Park ◽

Hyoung Ook Kim ◽

Nam Yeol Yim ◽

Byung Chan Lee ◽

Chan Park ◽

...

Keyword(s):

Case Report ◽

Inferior Vena Cava ◽

Stent Graft ◽

Inferior Vena ◽

Vena Cava ◽

Endovascular Management ◽

Top Down ◽

Life Threatening ◽

The Right ◽

Suprahepatic Inferior Vena Cava

Purpose The treatment of suprahepatic inferior vena cava (IVC) ruptures results in high mortality rates due to difficulty in performing the surgical procedure. Here, we present a case of successful endovascular management of a life-threatening suprahepatic IVC rupture with top-down placement of a stent graft. Case Report A 33-year-old woman was involved in a traffic accident and presented to our emergency department due to unstable hemodynamics after blunt abdominal wall trauma. Computed tomography (CT) revealed massive extravasation of contrast agent from the suprahepatic IVC, which suggested traumatic suprahepatic IVC rupture. To seal the IVC, to salvage major hepatic veins, and to prevent migration of the stent graft into the right side of the heart after placement, an aortic cuff with a proximal hook was introduced in a top-down direction via the right internal jugular vein. After closure of the injured IVC, the patient’s hemodynamics improved, and additional laparotomy was performed. After 3 months of trauma care, the patient recovered and was discharged. Follow-up CT after 58 months showed a patent stent graft within the IVC. Conclusion Endovascular management with top-down placement of a stent graft is a viable option for emergent damage control in patients with life-threatening hemorrhage from IVC rupture.

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Metastatic renal cell carcinoma extending to the left atrium through the inferior pulmonary vein

Interactive Cardiovascular and Thoracic Surgery ◽

10.1093/icvts/ivab018 ◽

2021 ◽

Author(s):

Alan G Dawson ◽

Cathy J Richards ◽

Leonidas Hadjinikolaou ◽

Apostolos Nakas

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Left Atrium ◽

Pulmonary Vein ◽

Metastatic Renal Cell Carcinoma ◽

Renal Cell ◽

Pulmonary Veins ◽

Lower Lobe ◽

Inferior Pulmonary Vein ◽

The Right

Abstract Metastatic renal cell carcinoma with involvement through the pulmonary veins to the left atrium is very rare. We report the case of a 70-year-old male with metastatic renal cell carcinoma to the right lower lobe of the lung abutting the inferior pulmonary vein with extension to the left atrium without pre-operative evidence. Surgical resection was achieved through a posterolateral thoracotomy. Lung masses that abut the pulmonary veins should prompt further investigation with a pre-operative transoesophageal echocardiogram to minimize unexpected intraoperative findings.

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