scholarly journals Coronary sinus atrial septal defects in adults over the past 20 years at new Tokyo hospital: case series

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Haruhiko Sugimori ◽  
Tatsuya Nakao ◽  
Yuki Ikegaya ◽  
Daisuke Iwahashi ◽  
Shoichi Tsuda ◽  
...  
Keyword(s):  
Coronary Sinus ◽  
Surgical Repair ◽  
Wide Spectrum ◽  
Superior Vena ◽  
Vena Cava ◽  
Case Series ◽  
Right Atrial ◽  
Valvular Regurgitation ◽  
Type Iv ◽  
The Right

Abstract Background An isolated coronary sinus (CS) atrial septal defect (ASD) is defined as a CS unroofed in the terminal portion without a persistent left superior vena cava or other anomalies. This defect is rare and part of the wide spectrum of unroofed CS syndrome (URCS). Recently, several reports have described this finding. The database of New Tokyo Hospital was searched to determine the incidence of this defect. Additionally, to raise awareness of this condition, the findings from five patients with CS ASD who underwent surgical repair at New Tokyo Hospital are discussed. Case presentation The patients were three women and two men with an age range of 63–77 years. All patients underwent transthoracic echocardiography and computed tomography, and one underwent magnetic resonance imaging. In two patients, the defect was found unexpectedly intraoperatively; left-to-right shunting was apparent in the other three patients preoperatively. The pulmonary-to-systemic blood flow ratio ranged from 1.42 to 3.1 following cardiac catheterization, and oxygen saturation step-up was seen on the right side of the heart. Valvular regurgitation was seen in 4/5 patients with different combinations and degrees of mitral, tricuspid, and aortic valve involvement. Right atrial and ventricular dilation were seen in 4/5 patients; three patients had left atrial dilation. Three patients experienced atrial fibrillation, and one of these also experienced paroxysmal ventricular contractions. All patients underwent surgical repair, and some underwent multiple procedures. One patient who had previously undergone kidney transplantation died approximately 1 year postoperatively; the remaining four patients are currently experiencing good activities of daily living without symptoms. Conclusions CS ASD (Kirklin and Barratt–Boyes type IV URCS) comprised 1.3% of adult congenital heart surgeries and 0.07% of adult open-heart surgeries at New Tokyo Hospital from 1999 to 2019. At New Tokyo Hospital, cardiac surgery is performed mainly for patients with acquired cardiac disease, and CS ASD is rare. Early diagnosis is important, as well as early surgical repair in symptomatic patients, especially those with blood access shunts, which may overload the heart. The case of a poor prognosis in this series is noteworthy, as similar cases have not been reported previously.

scholarly journals Coronary Sinus Atrial Septal Defects in Adults over the Past 20 Years at New Tokyo Hospital: Case Series

2021 ◽  
Author(s):  
Haruhiko Sugimori ◽  
Tatsuya Nakao ◽  
Yuki Ikegaya ◽  
Daisuke Iwahashi ◽  
Shoichi Tsuda ◽  
...  
Keyword(s):  
Coronary Sinus ◽  
Surgical Repair ◽  
Wide Spectrum ◽  
Superior Vena ◽  
Vena Cava ◽  
Case Series ◽  
Right Atrial ◽  
Valvular Regurgitation ◽  
Unroofed Coronary Sinus ◽  
Type Iv

Abstract Background: Isolated coronary sinus atrial septal defect (ASD) is defined as a coronary sinus unroofed in the terminal portion without a persistent left superior vena cava and other anomalies. This defect is rare and part of a wide spectrum of unroofed coronary sinus syndromes. Recently, several reports have described this finding. We searched the hospital’s database to determine the incidence of this defect, and to raise awareness of this condition, we discussed the findings from five patients with coronary sinus ASD who underwent surgical repair.Case presentation: The patients were three women and two men with an age range of 63–77 years. All patients underwent transthoracic echocardiography and computed tomography, and one underwent magnetic resonance imaging. In two patients, the defect was found unexpectedly intraoperatively; left-to-right shunting was apparent in the other three patients preoperatively. The pulmonary-to-systemic blood flow ratio ranged from 1.42 to 3.1 following cardiac catheterization, and oxygen saturation step-up was seen on the right side of the heart. Valvular regurgitation was seen in 4/5 patients with the mitral, tricuspid, and aortic valves involved in different combinations and to different degrees. Right atrial and ventricular dilation were seen in 4/5 patients; three patients had left atrial dilation. Three patients experienced atrial fibrillation, and one of these also experienced paroxysmal ventricular contractions. All patients underwent surgical repair, and some underwent multiple procedures. One patient who had previously undergone kidney transplantation died approximately 1 year postoperatively; the remaining four patients are currently experiencing good activities of daily living without symptoms. Conclusions: Coronary sinus ASD (Kirklin and Barratt–Boyes type IV unroofed coronary sinus syndrome) comprised 1.3% of adult congenital heart surgeries and 0.07% of adult open-heart surgeries in our hospital from 1999 to 2019. Our hospital performs cardiac surgery mainly for patients with acquired cardiac disease, and coronary sinus ASD is rare. Early diagnosis and, in symptomatic patients (especially those with blood access shunts, which may overload the heart), early surgical repair are important. The poorly prognostic case in our series is noteworthy, as similar cases have not been reported previously.

scholarly journals A Poorly Prognostic Case of Renal Dialysis in a 20-Year Case Series of Adult Coronary Sinus Atrial Septal Defect Repair at New Tokyo Hospital

2020 ◽  
Author(s):  
Haruhiko Sugimori ◽  
Tatsuya Nakao ◽  
Yuki Ikegaya ◽  
Daisuke Iwahashi ◽  
Shoich Tsuda ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Coronary Sinus ◽  
Septal Defect ◽  
Surgical Repair ◽  
Vena Cava ◽  
Case Series ◽  
Renal Dialysis ◽  
Right Atrial ◽  
Valvular Regurgitation ◽  
Unroofed Coronary Sinus

Abstract Background: Isolated coronary sinus atrial septal defect (ASD) is defined as a coronary sinus unroofed in the terminal portion without a persistent left superior vena cava and other anomalies. This defect is rare and part of a wide spectrum of unroofed coronary sinus syndromes. Recently, several reports have described this finding. We searched the hospital’s database to determine the incidence of this defect, and to raise awareness of this condition, we discussed the findings from five patients with coronary sinus ASD who underwent surgical repair. Case presentation: The patients were three women and two men with an age range of 63–77 years. All patients underwent transthoracic echocardiography and computed tomography, and one underwent magnetic resonance imaging. In two patients, the defect was found unexpectedly intraoperatively; left-to-right shunting was apparent in the other three patients preoperatively. The pulmonary-to-systemic blood flow ratio ranged from 1.42 to 3.1 following cardiac catheterization, and oxygen saturation step-up was seen on the right side of the heart. Valvular regurgitation was seen in 4/5 patients with the mitral, tricuspid, and aortic valves involved in different combinations and to different degrees. Right atrial and ventricular dilation were seen in 4/5 patients; three patients had left atrial dilation. Three patients experienced atrial fibrillation, and one of these also experienced paroxysmal ventricular contractions. All patients underwent surgical repair, and some underwent multiple procedures. One patient who had previously undergone kidney transplantation died approximately 1 year postoperatively; the remaining four patients are currently experiencing good activities of daily living without symptoms. Conclusions: Coronary sinus ASD (Kirklin and Barratt–Boyes type IV unroofed coronary sinus syndrome) comprised 1.3% of adult congenital heart surgeries and 0.07% of adult open-heart surgeries in our hospital from 1999 to 2019. Our hospital performs cardiac surgery mainly for patients with acquired cardiac disease, and coronary sinus ASD is rare. Early diagnosis and, in symptomatic patients (especially those with blood access shunts, which may overload the heart), early surgical repair are important. The poorly prognostic case in our series is noteworthy, as similar cases have not been reported previously.

scholarly journals Right-Sided Permanent Pacemaker Implantation in Patients with Persistent Left Superior Vena Cava with Absent Right Superior Vena Cava: 3-Case Series, Technique and Discussion

2021 ◽  
pp. 1-4
Author(s):  
Calin Siliste ◽  
Maria-Claudia-Berenice Suran ◽  
Calin Siliste ◽  
Andreea-Elena Velcea ◽  
Sebastian Stoica ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Case Series ◽  
Right Atrial ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
Ventricular Lead ◽  
Tertiary Center ◽  
The Right

Persistent left superior vena cava (PLSVC) is the most common variant of abnormal venous return to the heart. While usually asymptomatic, it is known to complicate transvenous cardiac procedures, such as implantation of cardiac electronic devices and ablations. PLSVC can present with or without the concomitant absence of right superior vena cava (RSVC). Depending on the operator's preference, implantation of permanent cardiac pacemakers (PPMs) may be performed from the left or right side. As most often the PLSVC is only identified at the time of intervention, it follows that the variant with the absence of RSVC can be diagnosed in practice only when implanting from the right side. For this reason, the true prevalence of this variant is largely unknown because most published cases of cardiac device implantations in patients with PLSVC have been performed from the left side. We present a short 3-case series of PPM implantations in a tertiary center from the right side in patients with PLSVC and absent RSVC. We found that the use of a standard curve for ventricular lead septal placement and a wide C-curve for right atrial lead placement in these patients was a feasible technique with good outcomes.

Atresia of the right atrial ostium of the coronary sinus without persistent left superior vena cava

2015 ◽  
Vol 9 (3) ◽  
pp. 227-229
Author(s):  
Nobuo Tomizawa ◽  
Masamichi Takahashi ◽  
Masakazu Kaneko ◽  
Kou Suzuki ◽  
Yujiro Matsuoka
Keyword(s):  
Superior Vena Cava ◽  
Coronary Sinus ◽  
Superior Vena ◽  
Vena Cava ◽  
Right Atrial ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
The Right

Usefulness of real-time three-dimensional trans-oesophageal echocardiography for detection of isolated unroofed coronary sinus

2014 ◽  
Vol 25 (1) ◽  
pp. 181-183 ◽  
Author(s):  
Yusuke Nakano ◽  
Mari Iwamoto ◽  
Munetaka Masuda
Keyword(s):  
Real Time ◽  
Coronary Sinus ◽  
Surgical Repair ◽  
Superior Vena ◽  
Three Dimensional ◽  
Vena Cava ◽  
Definite Diagnosis ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
Unroofed Coronary Sinus

AbstractWe report a case of unroofed coronary sinus not associated with the persistent left superior vena cava. Definite diagnosis of the unroofed coronary sinus was obtained by trans-oesophageal echocardiography, which revealed the unroofed portion with left-to-right shunt. Real-time three-dimensional trans-oesophageal echocardiography could show the whole pictures of the defect, which was useful information for surgical repair.

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

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

scholarly journals Intravenous Leiomyomatosis of the Uterus: A Retrospective Single-Center Study in 14 Cases

2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Qingbo Su ◽  
Xiquan Zhang ◽  
Hui Zhang ◽  
Yan Liu ◽  
Zhaoru Dong ◽  
...  
Keyword(s):  
Right Atrium ◽  
Superior Vena ◽  
Vena Cava ◽  
Right Atrial ◽  
Pelvic Cavity ◽  
Intravenous Leiomyomatosis ◽  
Abdominal Incision ◽  
Imaging Results ◽  
The Right

Purpose. This study aimed to retrospectively review the diagnosis and surgical treatment of uterine intravenous leiomyomatosis (IVL). Methods. The clinical data of 14 patients with uterine IVL admitted to our hospital between 2013 and 2018 were retrospectively analyzed, including their demographics, imaging results, surgical procedures, perioperative complications, and follow-up results. Results. The tumors were confined to the pelvic cavity in 7 patients, 1 into the inferior vena cava, 4 into the right atrium, and 2 into the pulmonary artery (including 1 into the superior vena cava). Only one case was misdiagnosed as right atrial myxoma before the operation, which was found during the surgery and was treated by staging surgery; all the other patients underwent one-stage surgical resection. Three patients underwent complete resection of the right atrial tumor through the abdominal incision, and one patient died of heart failure in the process of resection of heart tumor without abdominal surgery. During the 6–60 months of follow-up, 4 patients developed deep venous thrombosis of the lower extremity, and 1 patient developed ovarian vein thrombosis and pulmonary embolism. After anticoagulation treatment, the symptoms disappeared. One patient refused hysterectomy and the uterine fibroids recurred 4 years after the operation. Conclusion. Specific surgical plans for uterine IVL can be formulated according to cardiac ultrasound and computed tomography (CT). For the first type of tumor involving the right atrium, the right atrium tumor can be completely removed through the abdominal incision alone to avoid thoracotomy. The disease is at high risk of thrombosis and perioperative routine anticoagulation is required.

Repositioning of malpositioned peripherally inserted central catheter lines with the use of intracavitary electrocardiogram: A pediatric case series

2019 ◽  
Vol 21 (2) ◽  
pp. 259-264 ◽  
Author(s):  
Mark D Weber ◽  
Adam S Himebauch ◽  
Thomas Conlon
Keyword(s):  
Superior Vena ◽  
Vena Cava ◽  
Case Series ◽  
Right Atrial ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Case Presentation ◽  
Central Lines ◽  
Catheter Tip ◽  
Standard Radiographs

Introduction: Peripherally inserted central catheter tip migration is an infrequent event that occurs in neonatal, pediatric, and adult patients. We discuss a novel technique of utilizing intracavitary electrocardiogram to help confirm proper peripherally inserted central catheter tip repositioning, thereby reducing the need for serial radiographs. Case presentation: A case series of four patients will be discussed. The first three patients had peripherally inserted central catheter tips that were initially appropriately positioned but had later peripherally inserted central catheter tip migration. The use of intracavitary electrocardiogram was able to confirm the appropriate repositioning of the peripherally inserted central catheters without the need for serial radiographs. The fourth patient had several central lines in place, which led to difficulty in identifying the peripherally inserted central catheter tip location. The use of intracavitary electrocardiogram confirmed proper positioning of his peripherally inserted central catheter tip when standard radiographs could not provide clarity. Discussion: Several techniques have been published on methods to reposition a migrated peripherally inserted central catheter tip back to the superior vena cava/right atrial junction. These repositioning techniques often require fluoroscopic guidance or a confirmatory radiograph to assess the appropriate peripherally inserted central catheter tip location. At times, several radiographs may be required before the tip is successfully repositioned. This novel application of intracavitary electrocardiogram can help to minimize radiographs when peripherally inserted central catheter tip repositioning is required.

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