Morphology of the atriovenous junction and extensions of right atrial muscle towards the superior vena cava. A descriptive postmortem study. Implications for catheter ablation

Sinus venosus atrial septal defect (ASD) is usually associated with partial anomalous pulmonary venous return (PAPVR) of the right pulmonary veins to the superior vena cava (SVC), or to the SVC-right atrial junction. Standard procedure for repair of this defect is a patch roofing of the sinus venosus ASD and rerouting of pulmonary veins. However, the presence of SVC stenosis is a complication of this technique, and SVC augmentation is necessary in some cases. We present a simple technique for concomitant closure of sinus venosus ASD associated with PAPVR and augmentation of the SVC with a single autologous pericardial patch.

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Sinus Node Injury as a Result of Superior Vena Cava Isolation during Catheter Ablation for Atrial Fibrillation and Atrial Flutter

Pacing and Clinical Electrophysiology ◽

10.1111/j.1540-8159.2010.02903.x ◽

2010 ◽

Vol 34 (2) ◽

pp. 163-170 ◽

Cited By ~ 17

Author(s):

GANG CHEN ◽

JIAN ZENG DONG ◽

XING PENG LIU ◽

XIN YONG ZHANG ◽

DE YONG LONG ◽

...

Keyword(s):

Atrial Fibrillation ◽

Catheter Ablation ◽

Atrial Flutter ◽

Superior Vena Cava ◽

Superior Vena ◽

Sinus Node ◽

Vena Cava

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Localized reentry in the superior vena cava giving rise to an atypical right atrial flutter: Insights from an analysis of two cases

Journal of Electrocardiology ◽

10.1016/j.jelectrocard.2020.12.007 ◽

2021 ◽

Vol 64 ◽

pp. 91-94

Author(s):

Valentino Ducceschi ◽

Francesco Maddaluno

Keyword(s):

Atrial Flutter ◽

Superior Vena Cava ◽

Superior Vena ◽

Vena Cava ◽

Right Atrial

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Recurrent cardiac hydatid cyst located near the root of the superior vena cava and the interatrial septum: a case report

10.36811/jcshd.2022.110023 ◽

2022 ◽

pp. 1-4

Author(s):

Redha Lakehal ◽

Farid Aymer ◽

Soumaya Bendjaballah ◽

Rabah Daoud ◽

Khaled Khacha ◽

...

Keyword(s):

Hydatid Cyst ◽

Facial Paralysis ◽

Superior Vena Cava ◽

Superior Vena ◽

Vena Cava ◽

Lower Lobe ◽

Lateral Wall ◽

Right Atrial ◽

Risk Of Rupture ◽

The Right

Introduction: Cardiac localization of hydatid disease is rare (<3%) even in endemic countries. Affection characterized by a long functional tolerance and a large clinical and paraclinical polymorphism. Serious cardiac hydatitosis because of the risk of rupture requiring urgent surgery. The diagnosis is based on serology and echocardiography. The aim of this work is to show a case of recurrent cardiac hydatid cyst discovered incidentally during a facial paralysis assessment. Methods: We report the observation of a 26-year-old woman operated on in 2012 for pericardial hydatid cyst presenting a cardiac hydatid cyst located near the abutment of the SCV discovered incidentally during an exploration for left facial paralysis: NYHA stage II dyspnea. Chest x-ray: CTI at 0.48. ECG: RSR. Echocardiography: Image of cystic appearance at the level of the abutment of the SVC. SAPP: 38 mmhg, EF: 65%. Thoracic scan: 30/27 mm cardiac hydatid cyst bulging the lateral wall of the right atrium and the trunk of the right pulmonary artery with fissured cardiac hydatid cyst of the apical segment of the right lung of the right lower lobe with multiple bilateral intra parenchymal and sub pleural nodules. The patient was operated on under CPB. Intraoperative exploration: Presence of a hard and whitish mass, about 03 / 03cm developed in the full right atrial wall opposite the entrance to the superior vena cava. Procedure: Resection of the mass removing the roof of the LA, the AIS and the wall of the RA with reconstruction of the roof of the RA by patch in Dacron and reconstruction of the IAS and the wall of the RA by a single patch in Dacron. Results: The postoperative suites were simple. Conclusion: The hydatid cyst is still a real endemic in Algeria, the cardiac location is rare but serious and can constitute a real surgical emergency, hence the importance of prevention. Keywords: Hydatid cyst of the heart; Recurrence; Surgery; Cardiopulmonary Bypass; Prevention

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Macro-Reentrant Atrial Tachycardia Conducting Through a Left Superior Vena Cava After Catheter Ablation in a Patient With Paroxysmal Atrial Fibrillation

Canadian Journal of Cardiology ◽

10.1016/j.cjca.2014.09.024 ◽

2015 ◽

Vol 31 (1) ◽

pp. 103.e13-103.e15 ◽

Cited By ~ 1

Author(s):

Toshiya Kurotobi ◽

Naoto Kino ◽

Daisuke Tonomura ◽

Yoshihisa Shimada

Keyword(s):

Atrial Fibrillation ◽

Catheter Ablation ◽

Superior Vena Cava ◽

Paroxysmal Atrial Fibrillation ◽

Atrial Tachycardia ◽

Superior Vena ◽

Vena Cava ◽

Left Superior Vena Cava

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Superior Vena Cava Rupture Caused During Balloon Dilation for Treatment of SVC Syndrome Due to Repetitive Catheter Ablation

Angiology ◽

10.1177/000331970605700218 ◽

2006 ◽

Vol 57 (2) ◽

pp. 247-249 ◽

Cited By ~ 16

Author(s):

Kiyohiro Oshima ◽

Toru Takahashi ◽

Susumu Ishikawa ◽

Toshiteru Nagashima ◽

Keitaro Hirai ◽

...

Keyword(s):

Catheter Ablation ◽

Superior Vena Cava ◽

Superior Vena ◽

Balloon Dilation ◽

Vena Cava ◽

Svc Syndrome

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Experimental cardiac tamponade: correlation of pressure, flow velocity, and echocardiographic changes

Journal of Applied Physiology ◽

10.1152/jappl.1990.69.3.924 ◽

1990 ◽

Vol 69 (3) ◽

pp. 924-931 ◽

Cited By ~ 2

Author(s):

M. L. Cohen

Keyword(s):

Cardiac Tamponade ◽

Flow Velocity ◽

Superior Vena Cava ◽

Superior Vena ◽

Vena Cava ◽

Atrial Pressure ◽

Right Atrial ◽

Right Atrial Pressure ◽

Diastolic Flow ◽

Ventricular Filling

Seven episodes of experimental cardiac tamponade were induced in five anesthetized closed-chest dogs. Simultaneous pericardial and intracavitary pressures were synchronized with superior vena caval and transvalvular pulsed-Doppler flow tracings. The earliest indication of tamponade was the development of a negative transmural right atrial pressure that occurred during early ventricular diastole and was associated with echocardiographic evidence of right atrial collapse. This was also associated with reversal of diastolic flow in the superior vena cava and with diminished early diastolic flow velocity across the tricuspid as well as the mitral valve. During more advanced cardiac tamponade, the transmural right atrial pressure became negative during both early and late ventricular diastole as well as during isovolumic ventricular systole. This was associated with a disappearance of early diastolic ventricular filling and right ventricular diastolic collapse as observed on two-dimensional echocardiography. In hypotensive cardiac tamponade (cardiac output diminished by 70%), the decreased transmural right atrial pressure that developed during ventricular systole was accompanied by diminished antegrade flow in the superior vena cava. In advanced and hypotensive tamponade, ventricular filling occurred mainly during atrial contraction.

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Catheter ablation of atrial fibrillation in patients with persistent left superior vena cava is associated with major intraprocedural complications

Heart Rhythm ◽

10.1016/j.hrthm.2010.08.005 ◽

2010 ◽

Vol 7 (12) ◽

pp. 1755-1760 ◽

Cited By ~ 30

Author(s):

Erik Wissner ◽

Roland Tilz ◽

Melanie Konstantinidou ◽

Andreas Metzner ◽

Boris Schmidt ◽

...

Keyword(s):

Atrial Fibrillation ◽

Catheter Ablation ◽

Superior Vena Cava ◽

Superior Vena ◽

Vena Cava ◽

Left Superior Vena Cava ◽

Persistent Left Superior Vena

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Interatrial shunt for chronic pulmonary hypertension: differential impact of low-flow vs. high-flow shunting

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00496.2008 ◽

2009 ◽

Vol 296 (3) ◽

pp. H639-H644 ◽

Cited By ~ 17

Author(s):

Andreas Zierer ◽

Spencer J. Melby ◽

Rochus K. Voeller ◽

Marc R. Moon

Keyword(s):

Pulmonary Hypertension ◽

Cardiac Output ◽

Superior Vena Cava ◽

Diastolic Pressure ◽

Superior Vena ◽

Vena Cava ◽

High Flow ◽

Low Flow ◽

Right Atrial ◽

Chronic Pulmonary Hypertension

The purpose of the present study was to determine for the first time the qualitative and quantitative impact of varying degrees of interatrial shunting on right heart dynamics and systemic perfusion in subjects with chronic pulmonary hypertension (CPH). Eight dogs underwent 3 mo of progressive pulmonary artery banding, following which right atrial and ventricular end-systolic and end-diastolic pressure-volume relations were calculated using conductance catheters. An 8-mm shunt prosthesis was inserted between the superior vena cava and left atrium, yielding a controlled model of atrial septostomy. Data were obtained 1) preshunt or “CPH”; 2) “Low-Flow” shunt; and 3) “High-Flow” shunt (occluding superior vena cava forcing all flow through the shunt). With progressive shunting, right ventricular pressure fell from 72 ± 19 mmHg (CPH) to 54 ± 17 mmHg (Low-Flow) and 47 ± 17 mmHg (High-Flow) ( P < 0.001). Cardiac output increased from 1.5 ± 0.3 l/min at CPH to 1.8 ± 0.4 l/min at Low-Flow (286 ± 105 ml/min, 15% of cardiac output; P < 0.001), but returned to 1.6 ± 0.3 l/min at High-Flow (466 ± 172 ml/min, 29% of cardiac output; P = 0.008 vs. Low-Flow, P = 0.21 vs. CPH). There was a modest rise in systemic oxygen delivery from 252 ± 46 ml/min at CPH to 276 ± 50 ml/min at Low-Flow ( P = 0.07), but substantial fall to 222 ± 50 ml/min at High-Flow ( P = 0.005 vs. CPH, P < 0.001 vs. Low-Flow). With progressive shunting, bichamber contractility did not change ( P = 0.98), but the slope of the right atrial end-diastolic pressure volume relation decreased ( P < 0.04), consistent with improved compliance. This study demonstrated that Low-Flow interatrial shunting consistently improved right atrial mechanics and systemic perfusion in subjects with CPH, while High-Flow exceeded an “ideal shunt fraction”.

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