We Know What the Cardiac Surgeon Did during Last Hybrid Arrhythmia Procedure

2017 ◽  
Vol 12 (1) ◽  
pp. 67-70
Author(s):  
Narendra Kumar ◽  
Laurent Pison ◽  
Sandro Gelsomino ◽  
Ismail Aksoy ◽  
Mark La Meir ◽  
...  
Keyword(s):  
Atrial Tachycardia ◽  
Superior Vena ◽  
Sinus Node ◽  
Vena Cava ◽  
Interatrial Septum ◽  
Superior Part ◽  
Ectopic Beats ◽  
Cardiac Surgeon ◽  
Node Isolation ◽  
The Right

Superior vena cava (SVC) is an important source of origin of atrial fibrillation (AF) triggers other than a pulmonary vein. Because of the proximity of SVC-aorta ganglionic plexi to the SVC and the extension of myocardium in the SVC from the right atrium, SVC frequently becomes an important source of ectopic beats initiating AF. The potential complications of SVC isolation may include sinus node injury. Sinus node isolation was observed in a patient who had undergone previous surgical isolation of SVC for AF, while attempting to ablate endocardially, near the superior part of interatrial septum for an atrial tachycardia.

scholarly journals Coughing as a potentially effective induction method of atrial tachycardia: a case report

2020 ◽  
Author(s):  
Reina Tonegawa-Kuji ◽  
Kenichiro Yamagata ◽  
Kengo Kusano
Keyword(s):  
Pulmonary Vein ◽  
Atrial Tachycardia ◽  
Superior Vena ◽  
Vena Cava ◽  
P Wave ◽  
Induction Method ◽  
Voluntary Cough ◽  
Wave Morphology ◽  
The Right

Abstract Background  Cough-induced atrial tachycardia (AT) is extremely rare and its electrical origin remains largely unknown. Atrial tachycardias triggered by pharyngeal stimulation, such as swallowing or speech, appears to be more common and the majority of them originate from the superior vena cava or right superior pulmonary vein (PV). Only one case of swallow-triggered AT with right inferior pulmonary vein (RIPV) origin has been reported to date. Case summary  We present a case of a 41-year-old man with recurring episodes of AT in the daytime. He underwent electrophysiology study without sedation. Atrial tachycardia was not observed when the patient entered the examination room and could not be induced with conventional induction procedures. By having the patient cough periodically on purpose, transient AT with P-wave morphology similar to the clinical AT was consistently induced. Activation mapping of the AT revealed a centrifugal pattern with the earliest activity localized inside the RIPV. After successful radiofrequency isolation of the right PV, AT was no longer inducible. Discussion  In the rare case of cough-induced AT originating from the RIPV, the proximity of the inferior right ganglionated plexi (GP) suggests the role of GP in triggering tachycardia. This is the first report that demonstrates voluntary cough was used to induce AT. In such cases that induction of AT is difficult using conventional methods, having the patient cough may be an effective induction method that is easy to attempt.

scholarly journals Results of radiofrequency ablation of ectopic atrial tachycardia originating from the left superior vena cava in a patient with congenital heart disease

2021 ◽  
Vol 28 (3) ◽  
pp. 67-72
Author(s):  
E. V. Lubkina ◽  
S. Yu. Serguladze ◽  
Zh. Kh. Tembotova ◽  
I. I. Maslova ◽  
V. G. Suladze ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Cardiac Arrhythmias ◽  
Atrial Tachycardia ◽  
Congenital Heart ◽  
Superior Vena ◽  
Vena Cava ◽  
Left Superior Vena Cava ◽  
Ectopic Atrial Tachycardia ◽  
The Right ◽  
Dilated Coronary Sinus

Persistent left superior vena cava (PLSVC) is the most common anomaly of the thoracic veins (occurs in 0.2-0.6% of cases in the general population), in the vast majority of cases, PLSVC drains into the right atrium through the dilated coronary sinus and usually does not lead to significant hemodynamic disorders. The presence of PLSVC is often associated with cardiac arrhythmias; in this clinical case, we present the results of catheter ablation of arrhythmogenic foci in a 72-year-old patient with continuous-recurring ectopic tachycardia originating from the PLSVC.

scholarly journals Giant Interatrial Septal Lipoma Filling the Right Atrium Causing Slight Symptoms: A Case Report

2021 ◽  
Vol 24 (6) ◽  
pp. E947-E949
Author(s):  
Mingxiang Chen ◽  
Fuping Li ◽  
Haitao Zhang ◽  
Zhuyun Qin
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Right Atrium ◽  
Superior Vena ◽  
Vena Cava ◽  
Interatrial Septum ◽  
Illustrative Case ◽  
Cardiac Lipoma ◽  
The Right ◽  
Almost All

Cardiac lipoma is extremely rare. Here, we present a unique illustrative case of an interatrial septal lipoma protruding into the right atrium, causing symptoms in a 54-year-old male. Echocardiogram and computed tomography showed a well-shaped, giant, and fixed mass located in the interatrial septum and right atrium. The only manifestation was palpitation, though the mass filled almost all of the atrium and compressed the superior vena cava. The patient received resection of the large-sized lipoma, which was 87mm in diameter and weighed 300-400g. Pathological exam demonstrated mature lipocytes and substantiated the diagnosis of lipoma. The patient did well postoperatively, and symptoms were resolved.

Primary Cardiac Lipoblastoma

2001 ◽  
Vol 4 (3) ◽  
pp. 276-280 ◽  
Author(s):  
Megan K. Dishop ◽  
William N. O'Connor ◽  
Simon Abraham ◽  
Carol M. Cottrill
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Good Health ◽  
Interatrial Septum ◽  
Tissue Mass ◽  
Primary Cardiac Tumor ◽  
Vena Cava Syndrome ◽  
Anatomic Locations ◽  
The Right

Lipoblastoma is a benign adipose tumor in children that has been described in various anatomic locations, most commonly the extremities. We describe the case of a 17-month-old boy diagnosed with cardiac lipoblastoma, a previously unreported primary cardiac tumor in children. Our patient presented with symptoms of coughing, wheezing, and hoarseness and was found to have a large mediastinal mass, which narrowed the left mainstem bronchus and compressed the right atrium and superior vena cava, causing superior vena cava syndrome. Surgical exploration revealed an intrapericardial soft tissue mass arising from the area of the posterior interatrial septum. Grossly, the resected mass was lobulated, pale yellow, and fatty with focal areas of gray myxoid tissue. Microscopically, the tumor consisted of both immature and mature adipocytes, with focal vascular myxoid areas containing lipoblasts, diagnostic of lipoblastoma. Two months after surgery, the patient was in good health without evidence of recurrence.

Azygos Vein to the Rescue of Warden Anastomosis in High Pulmonary Venous Drainage

2018 ◽  
Vol 11 (4) ◽  
pp. NP210-NP212
Author(s):  
Siddharth Amboli ◽  
Yatindra U. Ashtaputre ◽  
Anuradha Kamath ◽  
Channabasavaraj S. Hiremath ◽  
Krishna Manohar
Keyword(s):  
Superior Vena ◽  
Sinus Node ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Azygos Vein ◽  
Growth Potential ◽  
Long Term Results ◽  
Pulmonary Venous Obstruction ◽  
Tension Free ◽  
The Right

Partial anomalous pulmonary venous return is a congenital anomaly in which some of the pulmonary veins drain into the right atrium or one of its venous tributaries. Although excellent long-term results have been described for the classic two-patch technique repair in older patients, The Warden procedure has an important role in smaller and younger patients and those patients in whom the superior vena cava (SVC) may be small and the right-sided pulmonary veins may connect high, at or above the azygos vein. In addition to prevention of early and late sinus node dysfunction, the Warden procedure helps to avoid systemic or pulmonary venous obstruction if care is taken to ensure a tension-free Warden anastomosis. Patch extension or interposition of prosthetic grafts with no growth potential have been used in instances of high partial anomalous pulmonary venous connection (PAPVC) to SVC. We report three cases of high PAPVC to SVC using an innovative technique of incorporating the azygos vein into the Warden anastomosis for a tension-free suture line.

scholarly journals Newly-found channels in the interatrial septum of the heart by dissection, histologic evaluation, and three-dimensional microcomputed tomography

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246585
Author(s):  
Mi-Sun Hur ◽  
Seunggyu Lee ◽  
Chang-Seok Oh ◽  
Yeon Hyeon Choe
Keyword(s):  
Superior Vena ◽  
Three Dimensional ◽  
Vena Cava ◽  
Interatrial Septum ◽  
Interatrial Communication ◽  
Left Border ◽  
Histologic Evaluation ◽  
Pass Through ◽  
Ischemic Attack ◽  
The Right

A minute thrombus can pass through a small type of interatrial communication, which can result in a stroke or transient ischemic attack and several associated symptoms. This study sought to investigate a new type of interatrial communication. Thirty-one hearts from embalmed adult cadavers were investigated. Each interatrial channels (IACs) was classified as either an open or obstructed channel according to the connection of each hole on the right and left surfaces of the interatrial septum. Open channels were found in two specimens (6.5%). Both open and obstructed IACs followed tortuous courses through the interatrial septum. On the right surface of the interatrial septum, the hole was usually found adjacent to the left border of the interatrial septum between the opening of the superior vena cava into the right atrium and the superior margin of the fossa ovalis. Conversely, holes on the left surface of the interatrial septum were usually found in the upper and middle parts adjacent to the left border of the interatrial septum. This novel finding is expected to support our understanding of the onset of possible symptoms such as stroke in the absence of classical atrial septal defects.

scholarly journals Compression of the Superior Vena Cava by an Interatrial Septal Lipoma: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
R. Grech ◽  
A. Mizzi ◽  
S. Grech
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Interatrial Septum ◽  
Fat Cells ◽  
Cardiac Tumours ◽  
Autopsy Series ◽  
Lipomatous Hypertrophy ◽  
Benign Tumours ◽  
The Right

Primary cardiac tumours are rare; their prevalence ranges from 0.0017% to 0.28% in various autopsy series. Cardiac lipomas are well-encapsulated benign tumours typically composed of mature fat cells, and their reported size ranges from 1 to 15 cm. They are usually seen in the left ventricle and the right atrium. Lipomas are true neoplasms, as opposed to lipomatous hypertrophy of the interatrial septum, which is a nonencapsulated hyperplastic accumulation of mature and foetal adipose tissue. Cardiac lipomas occur in patients of all ages, and the frequency of occurrence has been found to be equal in both sexes. Patients are usually asymptomatic, although the manifestation of symptoms depends upon both size and location of the tumour. We present the case of a patient with an interatrial septal lipoma, causing obstruction of the superior vena cava.

Management of Superior Vena Cava Occlusion Causing Bleeding “Downhill” Esophageal Varices

2021 ◽  
pp. 152660282198933
Author(s):  
Pablo V. Uceda ◽  
Julio Peralta Rodriguez ◽  
Hernán Vela ◽  
Adelina Lozano Miranda ◽  
Luis Vega Salvatierra ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Esophageal Varices ◽  
Superior Vena ◽  
Vena Cava ◽  
Central Venous Catheters ◽  
Dialysis Patients ◽  
Central Venous ◽  
Endovascular Recanalization ◽  
Flow Through ◽  
The Right

The health care system in Peru treats 15,000 dialysis patients annually. Approximately 45% of patients receive therapy using catheters. The incidence of catheter-induced superior vena cava (SVC) occlusion is increasing along with its associated significant morbidity and vascular access dysfunction. One of the unusual manifestations of this complication is bleeding “downhill” esophageal varices caused by reversal of blood flow through esophageal veins around the obstruction to the right atrium. Herein is presented the case of an 18-year-old woman on hemodialysis complicated by SVC occlusion and bleeding esophageal varices who underwent successful endovascular recanalization of the SVC. Bleeding from “downhill” esophageal varices should be considered in the differential diagnosis of dialysis patients exposed to central venous catheters. Aggressive endovascular treatment of SVC occlusion is recommended to preserve upper extremity access function and prevent bleeding from this complication.

Partial Anomalous Pulmonary Venous Connection: Forty-Six Years of Follow-Up

2021 ◽  
Vol 12 (1) ◽  
pp. 70-75
Author(s):  
Anne Kathrine M. Nielsen ◽  
Vibeke E. Hjortdal
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Sinus Node ◽  
Vena Cava ◽  
Node Disease ◽  
Sinus Node Disease ◽  
Patch Technique ◽  
Anomalous Pulmonary Venous Connection

Background: Surgical repair of partial anomalous pulmonary venous connection (PAPVC) may disturb the electrical conduction in the atria. This study documents long-term outcomes, including the late occurrence of atrial tachyarrhythmia and bradyarrhythmia. Methods: This retrospective study covers all PAPVC operations at Aarhus University Hospital between 1970 and 2010. Outcome measures were arrhythmias, sinus node disease, pacemaker implantation, pathway stenosis (pulmonary vein(s), intra-atrial pathway, and/or superior vena cava), and mortality. Data were collected from databases, surgical protocols, and hospital records until May 2018. Results: A total of 83 patients were included with a postoperative follow-up period up to 46 years. Average age at follow-up was 43 ± 21 years. During follow-up, new-onset atrial fibrillation or atrial flutter appeared in four patients (5%). Sinus node disease was present in nine patients (11%). A permanent pacemaker was implanted in seven patients (8%) at an average of 12.7 years after surgery. Pulmonary venous and/or superior vena cava obstruction was seen in five patients (6%). Stenosis was most prevalent in the two-patch technique, and arrhythmia was most prevalent in the single-patch technique. Sixty-seven (81%) of 83 patients had neither bradyarrhythmias nor tachyarrhythmias or pacemaker need. Conclusions: This study contributes important long-term data concerning the course of patients who have undergone repair of PAPVC. It confirms that PAPVC can be operated with low postoperative morbidity. However, late-onset stenosis, bradyarrhythmias and tachyarrhythmias, and need for pacemaker call for continued follow-up.

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