scholarly journals Sinus venosus atrial septal defect presenting with brain abscess in a 33-year-old man

2019 ◽  
Vol 11 (4) ◽  
pp. 322-324
Author(s):  
Roghayeh Pourkia ◽  
Seyed Habibollah Hassani ◽  
Simin Mouodi
Keyword(s):  
Atrial Septal Defect ◽  
Brain Abscess ◽  
Septal Defect ◽  
Vasogenic Edema ◽  
Brain Magnetic Resonance Imaging ◽  
Large Mass ◽  
Left Ventricular ◽  
Sinus Venosus ◽  
Right Atrial ◽  
Contrast Study

This study aimed to present a case of 33-year old man who was admitted with a history of one week headache and acute diplopia. No important finding was reported in his past medical history. Brain CT-scan revealed a large mass lesion in left parieto-occipital area with prominent vasogenic edema and midline shift. Brain magnetic resonance imaging (MRI) showed a mass with size of 5*4*5 centimeter with ring enhancement. After cranial surgery and removing the mass, transthoracic and transesophageal echocardiography (TEE) were conducted to find the source of brain abscess. Right ventricular (RV) and right atrial (RA) enlargement, significant left to right shunt, normal left ventricular (LV) and RV function, bidirectional shunt in addition to moderate size superior sinus venosus type atrial septal defect (ASD) were detected. Considering that most of brain abscesses have hematogenous source, a complete cardiac evaluation including TEE with contrast study is suggested for evaluation of patients with brain abscess.

Single-Patch Fold-Back Technique for Augmentation of the Superior Vena Cava in Sinus Venosus Atrial Septal Defect Associated with Partial Anomalous Pulmonary Venous Return

2015 ◽  
Vol 17 (6) ◽  
pp. 282
Author(s):  
Suguru Ohira ◽  
Kiyoshi Doi ◽  
Takeshi Nakamura ◽  
Hitoshi Yaku
Keyword(s):  
Atrial Septal Defect ◽  
Superior Vena Cava ◽  
Septal Defect ◽  
Venous Return ◽  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Sinus Venosus ◽  
Right Atrial ◽  
Anomalous Pulmonary Venous Return

Sinus venosus atrial septal defect (ASD) is usually associated with partial anomalous pulmonary venous return (PAPVR) of the right pulmonary veins to the superior vena cava (SVC), or to the SVC-right atrial junction. Standard procedure for repair of this defect is a patch roofing of the sinus venosus ASD and rerouting of pulmonary veins. However, the presence of SVC stenosis is a complication of this technique, and SVC augmentation is necessary in some cases. We present a simple technique for concomitant closure of sinus venosus ASD associated with PAPVR and augmentation of the SVC with a single autologous pericardial patch.

Response to fluid challenge in patients with atrial septal defect

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M D'Alto ◽  
M Chessa ◽  
G Gaio ◽  
G Santoro ◽  
M Giordano ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Vascular Resistance ◽  
Pulmonary Circulation ◽  
Septal Defect ◽  
Fluid Challenge ◽  
Left Ventricular ◽  
Percutaneous Closure ◽  
Right Atrial ◽  
Pulmonary Vascular Disease ◽  
Pulmonary Arterial

Abstract Background A fluid challenge test (FCT) with a rapid infusion of saline allows for discrimination between pre- and post-capillary pulmonary hypertension (PH) and may unmask hidden post-capillary PH. Patients with atrial septal defect (ASD) may develop pre- or post-capillary PH after shunt closure respectively in case of pulmonary vascular disease or left ventricular disease. Aim To evaluate the haemodynamic changes of the pulmonary circulation in ASD patients undergoing percutaneous closure with indicated according to the current ESC guidelines. Methods Twenty-three patients (mean age 42.9±12.4 years; 15 female) underwent right heart catheterization in basal conditions and after FCT (volume loading with rapid saline infusion of 7 ml/kg in 10 min) before percutaneous closure of the ASD. Right atrial pressure (RAP), systolic, mean and diastolic pulmonary arterial pressure (sPAP, mPAP and dPAP), pulmonary arterial wedge pressure (PAWP), cardiac output (CO), pulmonary vascular resistance (PVR), systemic vascular resistance (SVR) and the ratio between pulmonary and systemic flow (QP/QS) were calculated four times: before and after inflating the sizing balloon both at baseline and immediately after FCT (Fig. 1). Results The patients had an increase in pressures and flows after FCT with open ASD: mPAP (18.7±4.4 vs 16.7±4.6 mmHg, p<0.001), PAWP (11.3±3.1 vs 9.2±3.0 mmHg, p<0.001), QP (12.5±2.3 vs 10.3±2.0 l/min, p<0.001), and QS (6.6±1.4 vs 5.9±1.2 l/min, p<0.001) but RAP remained unchanged (8.7±3.0 vs 8.3±2.4 mmHg, p=0.35). PVR (0.2±0.4 vs 0.8±0.3 Wood Units, p<0.001) and SVR (11.2±3.2 vs 12.5±3.2 Wood Units, p=0.02) decreased, and PVR/SVR (0.06±0.02 vs 0.06±0.3, p=0.25) remained unchanged. QP/QS increased in all patients after FCT (mean±SD: 2.0±0.4 vs 1.8±0.4, p<0.001). During a temporary ASD closure by sizing balloon, the patients had increases of RAP (9.0±2.6 vs 7.6±2.6 mmHg, p<0.001) mPAP (19.5±4.0 vs 17.4±3.7 mmHg, p<0.001), PAWP (13.2±2.1 vs 11.2±2.9 mmHg, p<0.001), and CO (7.7±2.7 vs 6.8±2.3 l/min, p<0.001) after FCT. PVR remained unchanged (0.9±0.4 vs 1.1±0.6, p=0.12) and SVR reduced (9.8±2.7 vs 11.3±2.9, p<0.001) after FCT. Conclusions None of the reported ASD patients presented with FCT criteria of post-capillary PH (that is a PAWP >18 mmHg). The FCT was associated with an increase in QP/QS suggesting that the patients still had a distensible pulmonary circulation. Further studies are needed to explore the relevance of a FCT in ASD patients, particularly those with higher PVR values. Figure 1 Funding Acknowledgement Type of funding source: None

Association of Left Ventricular Diverticula and Sinus Venosus Atrial Septal Defect

2012 ◽  
pp. n/a-n/a
Author(s):  
Sedigheh Saedi ◽  
Abbas Salehi ◽  
Tahereh Saedi ◽  
Mohammad Jafar Hashemi
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Left Ventricular ◽  
Sinus Venosus

scholarly journals An adult patient with previously undiagnosed sinus venosus atrial septal defect presenting with brain abscess: a case report

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Navin Mathew ◽  
Nischal N Hegde
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Atrial Septal Defect ◽  
Adult Patient ◽  
Brain Abscess ◽  
Congenital Heart ◽  
Septal Defect ◽  
Contrast Echocardiography ◽  
Sinus Venosus ◽  
The Right

Abstract Background Brain abscess is a common complication in children with cyanotic congenital heart disease. The presence of an underlying acyanotic congenital heart disease is usually not suspected in an adult patient presenting with brain abscess. Case summary A 51-year-old male patient with no known co-morbidities came with complaints of recent onset right lower limb weakness needing support while walking and on evaluation was found to have brain abscess. He underwent robotic endoscope assisted endoport excision of the brain abscess. Two-dimensional transthoracic echocardiography showed right atrial and right ventricular dilatation with mild low-pressure tricuspid regurgitation. Transoesophageal echocardiography (TOE) revealed sinus venosus atrial septal defect (ASD) with left-to-right shunt with the right upper pulmonary vein draining into superior vena cava. Contrast echocardiography revealed a small transient right-to-left shunt. He has been advised to undergo elective surgical closure of ASD with partial anomalous pulmonary venous connection repair. Discussion Right-to-left shunting in ASDs can occur in the early systole even in the absence of raised pressures in the right side of the heart, even when the predominant shunt is left to right, but the magnitude of such a shunt is small and transient and is easily missed. Contrast echocardiography and TOE should be done as a part of evaluation of patients presenting with brain abscess.

Closure of Secundum Atrial Septal Defect with Autologous Right Atrial Patch: Case Report

2005 ◽  
Vol 8 (2) ◽  
pp. 96 ◽  
Author(s):  
Osman Tansel Dar�in ◽  
Alper Sami Kunt ◽  
Mehmet Halit Andac
Keyword(s):  
Atrial Septal Defect ◽  
Right Atrium ◽  
Septal Defect ◽  
Complete Recovery ◽  
Interatrial Septum ◽  
Right Atrial ◽  
Atrial Wall ◽  
Residual Shunt ◽  
Asd Closure ◽  
The Right

Background: Although various synthetic materials and pericardium have been used for atrial septal defect (ASD) closure, investigators are continuing to search for an ideal material for this procedure. We report and evaluate a case in which autologous right atrial wall tissue was used for ASD closure. Case: In this case, we closed a secundum ASD of a 22-year-old woman who also had right atrial enlargement due to the defect. After establishing standard bicaval cannulation and total cardiopulmonary bypass, we opened the right atrium with an oblique incision in a superior position to a standard incision. After examining the secundum ASD, we created a flap on the inferior rim of the atrial wall. A stay suture was stitched between the tip of the flap and the superior rim of the defect, and suturing was continued in a clockwise direction thereafter. Considering the size and shape of the defect, we incised the inferior attachment of the flap, and suturing was completed. Remnants of the flap on the inferior rim were resected, and the right atrium was closed in a similar fashion. Results: During an echocardiographic examination, neither a residual shunt nor perigraft thrombosis was seen on the interatrial septum. The patient was discharged with complete recovery. Conclusion: Autologous right atrial patch is an ideal material for ASD closure, especially in patients having a large right atrium. A complete coaptation was achieved because of the muscular nature of the right atrial tissue and its thickness, which is a closer match to the atrial septum than other materials.

Acute Changes in Left Ventricular End Diastolic Pressure following the Transcatheter Closure of an Atrial Septal Defect in Adults

2016 ◽  
Vol 19 (3) ◽  
pp. 145 ◽  
Author(s):  
Young Hwa Kong ◽  
Jinyoung Song ◽  
Kyung Hee Kim ◽  
June Huh ◽  
I-Seok Kang
Keyword(s):  
Elderly Patients ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Diastolic Pressure ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Device Closure ◽  
Acute Changes ◽  
Asd Closure

<strong>Background:</strong> Acute changes in left ventricular diastolic function shortly after ASD closure in elderly patients have not been well known. We aimed to investigate acute changes in left ventricular end diastolic pressure (LVEDP) in elderly patients following transcatheter closure of atrial septal defect (ASD). <br /><strong>Methods:</strong> All 19 adults with ASDs who underwent transcatheter closure between June 2013 and December 2014 were enrolled. LVEDP was measured prior to device closure and compared with that immediately following device closure and 15 minutes after device closure. <br /><strong>Results:</strong> The median age of the patients was 48 years old. The baseline E/e’ and LVEDP values were 8.3 ± 2.8 and 13 ± 3 mmHg. The LVEDP value immediately following closure was 19 ± 4 mmHg, and 15 minutes after closure was 16 ± 4 mmHg. The median increase in the LVEDP value immediately following closure was 6 mmHg, which significantly differed from that prior to closure. The LVEDP 15 minutes after closure decreased but remained significantly higher than the value observed immediately after closure. No significant changes were observed with regard to E/e’ at either 1 day or 3 months following closure. The LVEDP value <br />15 minutes after device closure was significantly correlated with those observed before closure and immediately following closure; however, no significant correlations were observed with regard to patient age, Qp/Qs, E/e’ before closure, or E/e’ 3 months after device closure.<br /><strong>Conclusion:</strong> LVEDP in adults with ASDs significantly increases following device closure. LVEDP before closure predicts LVEDP following device closure.

Cobra head deformity of atrial septal occluder: blessing in disguise

2020 ◽  
pp. 1-2
Author(s):  
Uma Devi Karuru ◽  
Saurabh Kumar Gupta
Keyword(s):  
Atrial Septal Defect ◽  
Left Atrial ◽  
Septal Defect ◽  
Atrial Septum ◽  
Right Atrial ◽  
Septal Occluder Device ◽  
Occluder Device ◽  
The Right

Abstract It is not uncommon to have prolapse of the atrial septal occluder device despite accurate measurement of atrial septal defect and an appropriately chosen device. This is particularly a problem in cases with large atrial septal defect with absent aortic rim. Various techniques have been described for successful implantation of atrial septal occluder in such a scenario. The essence of all these techniques is to prevent prolapse of the left atrial disc through the defect while the right atrial disc is being deployed. In this brief report, we illustrate the use of cobra head deformity of the device to successfully deploy the device across the atrial septum.

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