Atrial Septal Defect Closure via Left Subclavian Vein Approach in a Patient With Absent Inferior Vena Cava

2021 ◽  
pp. 215013512098380
Author(s):  
Yusuke Enta ◽  
Shunsuke Tatebe ◽  
Yoshikatsu Saiki ◽  
Norio Tada
Keyword(s):  
Inferior Vena Cava ◽  
Atrial Septal Defect ◽  
Subclavian Vein ◽  
Septal Defect ◽  
Inferior Vena ◽  
Transcatheter Closure ◽  
Vena Cava ◽  
Atrial Septal Defect Closure ◽  
Azygos Continuation ◽  
Left Subclavian Vein

Without the femoral venous approach, transcatheter closure of an atrial septal defect is challenging. We performed percutaneous closure via the left subclavian vein in a patient with absence of the inferior vena cava with azygos continuation. Considering that inferior vena cava anomalies are not extremely rare among those with congenital heart disease, the left subclavian vein approach can be an alternative to the femoral approach.

Transcatheter closure of atrial septal defect with deficient posterior-inferior or inferior vena cava rim under echocardiography only: a feasibility and safety analysis

2021 ◽  
pp. 1-8
Author(s):  
Liu Liu Huang ◽  
Ji Wu ◽  
Mai Chen ◽  
Chun Lan Jiang ◽  
De C. Zeng ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Inferior Vena ◽  
Transcatheter Closure ◽  
Vena Cava ◽  
Group Versus ◽  
Atrial Septal Defect Closure ◽  
Significant Difference

Abstract Background: The safe closure of atrial septal defect with deficient posterior-inferior or inferior vena cava rim is a controversial issue. Few studies have been conducted on the closure of atrial septal defect with deficient posterior-inferior or inferior vena cava rim without fluoroscopy. This study evaluated the feasibility and safety of echocardiography-guided transcatheter closure of atrial septal defect with deficient posterior-inferior or inferior vena cava rim. Methods: The data of 136 patients who underwent transcatheter atrial septal defect closure without fluoroscopy from March 2017 to March 2020 were retrospectively analysed. The patients were classified into the deficient (n = 45) and sufficient (n = 91) posterior-inferior or inferior vena cava rim groups. Procedure and the follow-up results were compared between the two groups. Results: Atrial septal defect indexed diameter and the device indexed diameter in the deficient rim group were both larger than that in the sufficient rim group (22.12 versus 17.38 mm/m2, p < 0.001; 24.77 versus 21.21 mm/m2, p = 0.003, respectively). There was no significant difference in the success rate of occlusion between two groups (97.78% in the deficient rim group versus 98.90% in the sufficient rim group, p = 1.000). During follow-up, the incidence of severe adverse cardiac events was not statistically significant (p = 0.551). Conclusions: Atrial septal defect with deficient posterior-inferior or inferior vena cava rim can safely undergo transcatheter closure under echocardiography alone if precisely evaluated with transesophageal or transthoracic echocardiography and the size of the occluder is appropriate. The mid-term results after closure are similar to that for an atrial septal defect with sufficient rim.

Unconventional deployment of atrial septal occluder in a patient with atrial septal defect, dextrocardia, and interrupted inferior vena cava

2020 ◽  
Vol 30 (8) ◽  
pp. 1206-1208
Author(s):  
Sreekanth Yerram ◽  
Sunitha Aramalla ◽  
Srinivas Bhyravavajhala
Keyword(s):  
Inferior Vena Cava ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Inferior Vena ◽  
Pulmonary Stenosis ◽  
Balloon Dilation ◽  
Vena Cava ◽  
Atrial Septal Defect Closure ◽  
Deployment Strategy ◽  
Valvular Pulmonary Stenosis

AbstractAn atrial septal defect is a rare anomaly in patients with interrupted inferior vena cava, which renders the percutaneous intervention more complex; and hence, innovative approaches should be sought. Dextrocardia further complicates the procedure, and traditional atrial septal device deployment methods cannot be employed. We report a successful percutaneous secundum atrial septal defect closure by a novel deployment strategy along with balloon dilation of associated severe valvular pulmonary stenosis in a patient with dextrocardia and interrupted inferior vena cava.

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