Intracardiac or extracardiac conduit modification of the Fontan procedure in hearts with univentricular atrioventricular connection and left superior caval vein draining to coronary sinus

1997 ◽  
Vol 7 (2) ◽  
pp. 215-219
Author(s):  
Jacques A.M. van Son ◽  
Volkmar Falk ◽  
Friedrich W. Mohr
Keyword(s):  
Coronary Sinus ◽  
Venous Blood ◽  
Azygos Vein ◽  
Caval Vein ◽  
Arterial Circulation ◽  
Superior Caval Vein ◽  
Inferior Caval Vein ◽  
Extracardiac Conduit ◽  
Hepatic Venous Blood ◽  
Pulmonary Arterial

AbstractIn 3 patients with isomeric morphologically left atrial appendages, univentricular atrioventricular connection, concordant ventriculoarterial connections, bilateral superior caval veins, with the left one draining via the coronary sinus, together with absence of any communicating vein, interruption of inferior caval vein with drainage via a right-sided (n=2) or left-sided (n=l) azygos vein, the hepatic venous blood was rerouted via the large coronary sinus into the pulmonary arterial circulation. In a fourth patient with similar pathology, having interruption of the left-sided inferior caval vein with drainage to the left-sided superior caval vein via a left-sided azygos vein and a large communicating vein, the pathway from the left superior caval vein to the coronary sinus was correspondingly small. An extracardiac conduit was therefore constructed between the hepatic veins and the left pulmonary artery so as to reroute the hepatic venous blood into the pulmonary arterial circulation. At a mean follow-up of 8.5 months, all patients are clinically well and none of them have developed pulmonary arteriovenous malformations. To avoid the latter complication in Fontan physiology, especially in the setting of an interrupted inferior caval vein with drainage via the azygos vein, we believe that it is preferable to reroute the hepatic venous blood into the pulmonary circulation.

Echocardiographic diagnosis of totally anomalous pulmonary venous connection to the azygos vein

1999 ◽  
Vol 9 (3) ◽  
pp. 305-309 ◽  
Author(s):  
Anna Maria Musolino ◽  
Giuseppe Santoro ◽  
Bruno Marino ◽  
Roberto Formigari ◽  
Paolo Guccione ◽  
...  
Keyword(s):  
Venous Blood ◽  
Azygos Vein ◽  
Caval Vein ◽  
Superior Caval Vein ◽  
Heart Malformation ◽  
Precise Diagnosis ◽  
Right Pulmonary Artery ◽  
The Right ◽  
Anomalous Pulmonary Venous Connection ◽  
Axis View

AbstractTotally anomalous pulmonary venous connection to the azygos vein is a rare congenital heart malformation in which all the pulmonary venous blood returns anomalously to the azygos vein. Among 111 consecutive patients with totally anomalous pulmonary venous connection undergoing surgical correction at our institution between June 1982 and September 1997, this malformation was present in seven cases. By echocardiography, using a subxyphoid short-axis view at the atrial level and a modified suprasternal sagittal view, the malformation was diagnosed when the pulmonary venous confluence was traced posteriorly and superiorly relative to the right pulmonary artery and right bronchus, finally reaching reach the superior caval vein. Totally anomalous pulmonary venous connection to the azygos vein was misdiagnosed in the first two patients, both by echocardiography and angiocardiography. In the subsequent five patients, a precise diagnosis was obtained by echocardiography. Echocardiography, therefore, can be considered an accurate diagnostic tool permitting recognition of totally anomalous pulmonary venous connection to the azygos vein, and permitting corrective surgery without recourse to catheterization and angiography.

Transcatheter therapy of anomalous systemic venous drainage

2017 ◽  
Vol 28 (3) ◽  
pp. 502-506
Author(s):  
Shahnawaz M. Amdani ◽  
Thomas J. Forbes ◽  
Daisuke Kobayashi
Keyword(s):  
Left Atrium ◽  
Pulmonary Vein ◽  
Pulmonary Veins ◽  
Three Dimensional ◽  
Venous Drainage ◽  
Azygos Vein ◽  
Caval Vein ◽  
Superior Caval Vein ◽  
Inferior Caval Vein ◽  
The Right

AbstractAnomalous drainage of the right superior caval vein into the left atrium is a rare congenital anomaly that causes cyanosis and occult infection owing to right-to-left shunting. Transcatheter management of this anomaly is unique and rarely reported. We report a 32-year-old man with a history of brain abscess, who was diagnosed with an anomalous right superior caval vein draining to the left atrium; right upper pulmonary vein and right middle pulmonary vein draining into the inferior portion of the right superior caval vein; and a left superior caval vein draining into the right atrium through the coronary sinus without a bridging vein. Pre-procedural planning was guided by three-dimensional printed model. The right superior caval vein was occluded with a 16-mm Amplatzer muscular Ventricular Septal Defect occluder inferior to the azygous vein, but superior to the entries of right upper and middle pulmonary veins. This diverted the right superior caval vein flow to the inferior caval vein system through the azygos vein in a retrograde manner and allowed the right upper pulmonary vein and right middle pulmonary vein flow to drain into the left atrium normally, achieving exclusion of right-to-left shunting and allowing normal drainage of pulmonary veins into the left atrium. At the 6-month follow-up, his saturation improved from 93 to 97% with no symptoms of superior caval vein syndrome.

Repair of divided left atrium associated with unroofed coronary sinus

1998 ◽  
Vol 8 (2) ◽  
pp. 253-255 ◽  
Author(s):  
Jacques A.M. van Son ◽  
Thomas Walther ◽  
Friedrich W. Mohr
Keyword(s):  
Mitral Valve ◽  
Left Atrium ◽  
Coronary Sinus ◽  
Venous Blood ◽  
Young Infant ◽  
Caval Vein ◽  
Unroofed Coronary Sinus ◽  
Autologous Pericardium ◽  
Superior Caval Vein ◽  
Unroofed Coronary Sinus Syndrome

AbstractIn a young infant with divided left atrium, unroofed coronary sinus syndrome, and persistent left superior caval vein, the pulmonary venous blood was successfully routed, after atrial septectomy, to the mitral valve by constructing a baffle using the partially detached diaphragm which had initially separated the pulmonary venous and vestibular components of the left atrium. The baffle was augmented with a patch of untreated autologous pericardium.

Slow pathway cryoablation in a child with absent right superior caval vein and persistent left superior caval vein draining into the coronary sinus

2015 ◽  
Vol 178 ◽  
pp. 178-180
Author(s):  
Alfredo Di Pino ◽  
Elio Caruso ◽  
Placido Gitto ◽  
Luca Costanzo ◽  
Salvatore Patanè ◽  
...  
Keyword(s):  
Coronary Sinus ◽  
Slow Pathway ◽  
Caval Vein ◽  
Superior Caval Vein

Right-to-left shunt through the cardiac veins after the Fontan procedure

2000 ◽  
Vol 10 (4) ◽  
pp. 416-418 ◽  
Author(s):  
Hideki Uemura ◽  
Toshikatsu Yagihara ◽  
Osamu Monta
Keyword(s):  
Coronary Sinus ◽  
Fontan Procedure ◽  
The Other ◽  
Caval Vein ◽  
Postoperative Course ◽  
Superior Caval Vein ◽  
Cardiac Veins

AbstractWe found right-to-left shunts through the cardiac veins postoperatively in 2 patients who had undergone the Fontan procedure. In one of the patients, channels were present through the cardiac veins independent of the coronary sinus. In the other patient, an atretic orifice for the coronary sinus, coupled with a persistent left-sided superior caval vein, complicated the postoperative course.

Left-sided hepatic vein connected to the coronary sinus

1996 ◽  
Vol 6 (2) ◽  
pp. 190-192 ◽  
Author(s):  
László Király ◽  
John E. Deanfield ◽  
Marc R. de Leval
Keyword(s):  
Hepatic Vein ◽  
Coronary Sinus ◽  
Left Atrial ◽  
Septal Defect ◽  
Atrioventricular Septal Defect ◽  
Rare Entity ◽  
Biventricular Repair ◽  
Caval Vein ◽  
Inferior Caval Vein ◽  
Complete Atrioventricular

AbstractA left-sided hepatic vein connected to the coronary sinus is reported in a case of a 22-month-old boy with isomerism of the left atrial appendages, complete atrioventricular septal defect and azygous continuation of the inferior caval vein. The diagnosis of the anomalous hepatic vein was made intraoperatively and successful biventricular repair has been accomplished. To the best of our knowledge, this is the first communication on this peculiar entity diagnosed during life, notwithstanding Nabarro's description of a similar autopsy finding in 1903. Aspects of the development of this rare entity are discussed.

Hybrid closure of a large atrial septal defect using Occlutech Flex II septal occluder in a patient with interrupted inferior caval vein

2020 ◽  
Vol 30 (6) ◽  
pp. 880-882
Author(s):  
Amjad Bani Hani ◽  
Mai Abdullattif ◽  
Iyad AL-Ammouri
Keyword(s):  
Cardiopulmonary Bypass ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Caval Vein ◽  
Superior Caval Vein ◽  
Inferior Caval Vein ◽  
Thoracotomy Incision

AbstractWe present a case of a 31-year-old male with a large atrial septal defect, who was found to have interrupted inferior caval vein with azygous continuation to the superior caval vein, which precluded transcutaneous closure by device. The defect was successfully closed with a 33 mm Occlutech Figula septal occluder using a sub-mammary small thoracotomy incision and per-atrial approach without using cardiopulmonary bypass. The patient was discharged home after 48 hours of procedure.

Bidirectional coronary venous return in the partial unroofed coronary sinus syndrome complicated by coronary sinus orifice atresia

2020 ◽  
Vol 30 (4) ◽  
pp. 582-584 ◽  
Author(s):  
Dai Asada ◽  
Hisato Ito
Keyword(s):  
Coronary Sinus ◽  
Venous Return ◽  
Paradoxical Embolism ◽  
Pressure Balance ◽  
Caval Vein ◽  
Unroofed Coronary Sinus ◽  
Superior Caval Vein ◽  
Systemic Vein ◽  
Coronary Sinus Orifice Atresia ◽  
Unroofed Coronary Sinus Syndrome

AbstractUnroofed coronary sinus syndrome complicated by coronary sinus orifice atresia is a rare congenital anomaly. There are two alternate exits for coronary venous return: unroofed coronary sinus and persistent left superior caval vein. The coronary venous direction could be bidirectional depending on the pressure balance between the left atrium and the systemic vein. This anomaly has the risk of heart failure, paradoxical embolism, and cyanosis.

“Shunt index” can be used to predict clinically significant patent ductus arteriosus in premature neonates in early post-natal life

2013 ◽  
Vol 24 (4) ◽  
pp. 605-609 ◽  
Author(s):  
Ece Yapakçı ◽  
Ayşe Ecevit ◽  
Birgin Törer ◽  
Deniz Anuk Ince ◽  
Mahmut Gökdemir ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Oxygen Saturation ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Venous Blood ◽  
Blood Gases ◽  
Oxygen Extraction ◽  
Caval Vein ◽  
Inferior Caval Vein ◽  
Patent Ductus

AbstractBackground: This study aimed to examine the differences between arterial and inferior caval vein oxygen saturation, fractional oxygen extraction, and the shunt index, which were calculated in the diagnosis of patent ductus arteriosus. Methods: Twenty-seven preterm infants were included in this study and were divided into two groups according to patent ductus arteriosus. Among them, 11 (41%) infants had haemodynamically significant patent ductus arteriosus and 16 (59%) did not have significant patent ductus arteriosus. Synchronous arterial and venous blood gases were measured during the first post-natal hours after the insertion of umbilical catheters. The differences between arterial and inferior caval vein oxygen saturation, inferior body fractional oxygen extraction, and the shunt index were calculated. Echocardiography was performed before the 72nd hour of life in a selected group of patients who had haemodynamically significant patent ductus arteriosus. Ibuprofen treatment was administered to patients with patent ductus arteriosus. Echocardiography was performed on the 72nd hour of life in preterm infants without any clinical suspicion of patent ductus arteriosus. Results: The early measured differences between arterial and inferior caval vein oxygen saturation and inferior body fractional oxygen extraction were found to be lower and the shunt index was found to be higher in the haemodynamically significant patent ductus arteriosus group than in the group without haemodynamically significant patent ductus arteriosus. Conclusion: We found that the shunt index, calculated in the first hours of life as ≥63%, predicted haemodynamically significant patent ductus arteriosus with a sensitivity of 78% and specificity of 82% in preterm newborns.

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