An Efficient Assisted Bidirectional Glenn Design With Lowered Superior Vena Cava Pressure for Stage-One Single Ventricle Patients

2021 ◽  
Vol 143 (7) ◽  
Author(s):  
Dongjie Jia ◽  
Matthew Peroni ◽  
Tigran Khalapyan ◽  
Mahdi Esmaily
Keyword(s):  
Superior Vena Cava ◽  
Single Ventricle ◽  
Superior Vena ◽  
Vena Cava ◽  
Bidirectional Glenn ◽  
Pulmonary Flow ◽  
Optimization Study ◽  
Shaped Nozzle ◽  
The Right ◽  
Brachiocephalic Veins

Abstract Recently, the assisted bidirectional Glenn (ABG) procedure has been proposed as an alternative to the modified Blalock–Taussig shunt (mBTS) operation for neonates with single-ventricle physiology. Despite success in reducing heart workload and maintaining sufficient pulmonary flow, the ABG also raised the superior vena cava (SVC) pressure to a level that may not be tolerated by infants. To lower the SVC pressure, we propose a modified version of the ABG (mABG), in which a shunt with a slit-shaped nozzle exit is inserted at the junction of the right and left brachiocephalic veins. The proposed operation is compared against the ABG, the mBTS, and the bidirectional Glenn (BDG) operations using closed-loop multiscale simulations. Both normal (2.3 Wood units-m2) and high (7 Wood units-m2) pulmonary vascular resistance (PVR) values are simulated. The mABG provides the highest oxygen saturation, oxygen delivery, and pulmonary flow rate in comparison to the BDG and the ABG. At normal PVR, the SVC pressure is significantly reduced below that of the ABG and the BDG (mABG: 4; ABG: 8; BDG: 6; mBTS: 3 mmHg). However, the SVC pressure remains high at high PVR (mABG: 15; ABG: 16; BDG: 12; mBTS: 3 mmHg), motivating an optimization study to improve the ABG hemodynamics efficiency for a broader range of conditions in the future. Overall, the mABG preserves all advantages of the original ABG procedure while reducing the SVC pressure at normal PVR.

Persistent left superior vena cava and its clinical correlation - A cadaveric study

2021 ◽  
Vol 12 (4) ◽  
pp. 118-121
Author(s):  
Sachendra Kumar Mittal ◽  
Rekha Parashar ◽  
Pankaj Kumar Singh ◽  
Leena Jadon
Keyword(s):  
Superior Vena Cava ◽  
Right Atrium ◽  
Superior Vena ◽  
Vena Cava ◽  
Medical Sciences ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
Male Cadaver ◽  
The Right ◽  
Brachiocephalic Veins

Background: Presented is a case of persistent left superior vena cava draining into the right atrium through coronary sinus and finally opens into right atrium. Abnormalities of the vascular system are more commonly seen due to its importance in circulation. Persistent left superior vena cava is rare but important congenital vascular anomaly. It results when the left superior cardinal vein caudal to the innominate vein fails to regress.The venous anomaly of a persistent left superior vena cava (PLSVC) affects 0.3%–0.5% of the general population. Normally the superior vena cava is a single vascular structure formed by the union of right and left brachiocephalic veins which are in turn formed by the union of internal jugular and subclavian veins of corresponding side, draining the head and neck as well as the superior extremity. Aims and Objective: To evaluate the accuracy of persistent left superior vena cava and to find out the opening of PLSVC and formations of both SVC. Materials and Methods: During routine dissection of Thorax, we have opened the thoracic cage and take out the Heart. during that we found separate SVC and then we did the study on this PLSVC in the Department of Anatomy, Jaipur National University Institute for Medical Sciences and Research Centre (JNUIMSRC) Jaipur and National Institute of Medical Sciences and Research (NIMS & R). Results: We found persistent left superior vena cava in two cadavers out of 30 cadavers (6.66%) one was 64-year-old male cadaver and another 72-year-old male cadaver. Both the vena cavae were formed as of brachiocephalic veins of the corresponding side. The persistent left superior vena cava opened into the enlarged coronary sinus that drained into the right atrium between the opening of inferior vena cava and right atrio-ventricular orifice. Conclusion: It has important clinical implications in certain clinical interventions. It may complicate placementof cardiac catheters or pacemaker leads.

Mediastinal Epithelioid Hemangioendothelioma Invading Superior Vena Cava: A Case Report and Review of Literature

2019 ◽  
Vol 15 (3) ◽  
pp. 349-352
Author(s):  
Su Hong Kim ◽  
Young Seon Kim ◽  
Min Hye Jang ◽  
Hee Jung Kwon
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Anterior Mediastinum ◽  
Epithelioid Hemangioendothelioma ◽  
Vascular Neoplasm ◽  
Case Presentation ◽  
Contrast Enhanced ◽  
The Right ◽  
Brachiocephalic Veins

Introduction: Epithelioid Hemangioendothelioma (EHE) is a rare vascular neoplasm. Common locations of EHE are the bone, soft tissue, liver, and lung, but the mediastinal location is extremely rare. Few cases of mediastinal EHE, invading the Superior Vena Cava (SVC) have been reported. </P><P> Case Presentation: We report a case of a 21-year-old man with EHE invading the SVC, which was incidentally detected on performing chest radiography. A contrast-enhanced chest Computed Tomography (CT) scan demonstrated a well-defined, oval mass located on the right side of the anterior mediastinum. The mass showed homogeneous enhancement with punctate calcifications, and it invaded the SVC at the confluence area of the right and left brachiocephalic veins. Conclusion: Mediastinal EHE invading the SVC may present as a homogeneously enhancing mass with punctate calcifications. It should be added to the differential diagnosis of tumors of the mediastinum. Accurate preoperative diagnosis of EHE is critical for surgical planning; therefore, knowledge of the radiologic features of EHE is important.

scholarly journals DOUBLE SUPERIORVENACAVA AND ITS ASSOCIATED CLINICAL IMPLICATIONS - A CASE REPORT AND LITERATURE REVIEW

2015 ◽  
Vol 05 (01) ◽  
pp. 075-078
Author(s):  
Sushma R Kotian ◽  
Antony Sylvan D Souza ◽  
Praveena Ravichandran ◽  
Pallavi Bhat ◽  
Mamatha Hosapatna
Keyword(s):  
Superior Vena Cava ◽  
Vascular System ◽  
Superior Vena ◽  
Vena Cava ◽  
Clinical Implications ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
Male Cadaver ◽  
The Right ◽  
Brachiocephalic Veins

AbstractAbnormalities of the vascular system are always of extreme interest due to its importance in circulation. Normally the superior vena cava is a single vascular structure formed by the union of right and left brachiocephalic veins which are in turn formed by the union of corresponding internal jugular and subclavian veins, draining the head and neck as well as the superior extremity. However during routine dissection in the Department of Anatomy, Kasturba Medical College, Manipal, we came across a case of double superior vena cava with persistent left superior vena cava in a 58-year-old male cadaver. Both the vena cavae were formed as continuations of brachiocephalic veins of the corresponding side. The persistent left superior vena cava opened into the enlarged coronary sinus that drained into the right atrium between the opening of inferior venacava and right atrioventricular orifice. No communication was observed between the two vena cavae. A persistent left superior vena cava does not by itself produce any physiological derangement. But it has important clinical implications in certain clinical interventions. It may complicate placement of cardiac catheters or pacemaker leads. Awareness of this anomaly may therefore reduce confusions and thus would help to avoid further complications.

A Case Report of Reconstruction of the Left Superior Vena Cava Using the Right Superior Vena Cava Autograft at Bilateral Bidirectional Superior Cavopulmonary Anastomosis

2017 ◽  
Vol 11 (4) ◽  
pp. NP63-NP65
Author(s):  
Shuichi Shiraishi ◽  
Ai Sugimoto ◽  
Jiyong Moon ◽  
Masashi Takahashi ◽  
Masanori Tsuchida
Keyword(s):  
Superior Vena Cava ◽  
Pediatric Patients ◽  
Single Ventricle ◽  
Superior Vena ◽  
Vena Cava ◽  
Graft Material ◽  
Left Superior Vena Cava ◽  
Single Ventricle Physiology ◽  
Cavopulmonary Anastomosis ◽  
The Right

The choice of graft material for reconstruction of the vena cava in pediatric patients remains controversial. We successfully treated an eight-month-old female patient with single ventricle physiology and long segment obstruction of the left superior vena cava using the right superior vena cava autograft at the time of bilateral bidirectional superior cavopulmonary anastomosis. Postoperative computed tomography confirmed the patency of the reconstruction.

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.

scholarly journals A Rare Case Report of Unusual Path of Left Internal Jugular Central Line

2021 ◽  
pp. 1-3
Author(s):  
Rajashekar Rangappa Mudaraddi ◽  
Hany Fawzi Greiss ◽  
Navin Kumar Manickam
Keyword(s):  
Superior Vena Cava ◽  
Case Reports ◽  
Superior Vena ◽  
Vena Cava ◽  
Central Line ◽  
Left Superior Vena Cava ◽  
Common Procedure ◽  
Rare Case Report ◽  
The Right ◽  
Line Path

Central venous cannulation is the most common procedure performed in perioperative setting and intensive care unit. Many case reports reported unusual positioning of central line catheters. Here, we would like to report a case of central line path in persistent left superior vena cava, a rare entity with a course similar to the right internal jugular central line. Preoperative computed tomography chest showed duplex superior vena cava which was not reported.

scholarly journals P649 Before and after: sinus venosus atrial septal defect

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
I Marco Clement ◽  
R Eiros ◽  
R Dalmau ◽  
T Lopez ◽  
G Guzman ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Left Atrium ◽  
Atrial Flutter ◽  
Superior Vena Cava ◽  
Right Atrium ◽  
Septal Defect ◽  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
The Right

Abstract Introduction The diagnosis of sinus venosus atrial septal defect (SVASD) is complex and requires special imaging. Surgery is the conventional treatment; however, transcatheter repair may become an attractive option. Case report A 60 year-old woman was admitted to the cardiology department with several episodes of paroxysmal atrial flutter, atrial fibrillation and atrioventricular nodal reentrant tachycardia. She reported a 10-year history of occasional palpitations which had not been studied. A transthoracic echocardiography revealed severe right ventricle dilatation and moderate dysfunction. Right volume overload appeared to be secondary to a superior SVASD with partial anomalous pulmonary venous drainage. A transesophageal echocardiography confirmed the diagnosis revealing a large SVASD of 16x12 mm (Figure A) with left-right shunt (Qp/Qs 2,2) and two right pulmonary veins draining into the right superior vena cava. Additionally, it demonstrated coronary sinus dilatation secondary to persistent left superior vena cava. CMR and cardiac CT showed right superior and middle pulmonary veins draining into the right superior vena cava 18 mm above the septal defect (Figures B and C). After discussion in clinical session, a percutaneous approach was planned to correct the septal defect and anomalous pulmonary drainage. For this purpose, anatomical data obtained from CMR and CT was needed to plan the procedure. During the intervention two stents graft were deployed in the right superior vena cava. The distal stent was flared at the septal defect level so as to occlude it while redirecting the anomalous pulmonary venous flow to the left atrium (Figure D). Control CT confirmed the complete occlusion of the SVASD without residual communication from pulmonary veins to the right superior vena cava or the right atrium (Figure E). Anomalous right superior and middle pulmonary veins drained into the left atrium below the stents. Transthoracic echocardiographies showed progressive reduction of right atrium and ventricle dilatation. The patient also underwent successful ablation of atrial flutter and intranodal tachycardia. She is currently asymptomatic, without dyspnea or arrhythmic recurrences. Conclusions In this case, multimodality imaging played a key role in every stage of the clinical process. First, it provided the diagnosis and enabled an accurate understanding of the patient’s anatomy, particularly of the anomalous pulmonary venous connections. Secondly, it allowed a transcatheter approach by supplying essential information to guide the procedure. Finally, it assessed the effectiveness of the intervention and the improvement in cardiac hemodynamics during follow-up. Abstract P649 Figure.

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