ANOMALIES OF THE PULMONARY VEINS AND THEIR SURGICAL SIGNIFICANCE

PEDIATRICS ◽  
1952 ◽  
Vol 9 (2) ◽  
pp. 152-166
Author(s):  
HARRY G. PARSONS ◽  
ANN PURDY ◽  
BRUCE JESSUP
Keyword(s):  
Superior Vena Cava ◽  
Clinical Symptoms ◽  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Ductus Venosus ◽  
Return Flow ◽  
Right Heart ◽  
Surgical Measures ◽  
The Right

The successful operations upon abnormalities of the outflow tracts of the heart suggest that surgical measures may also be applied to the correction of abnormal inflow tracts. Technically the anastomosis of veins to the auricle has been proved feasible in the experimental animal. Therefore, it should be possible to correct abnormally placed pulmonary veins in man. A wide variety of such anomalies occur. In 55 of 136 reported cases, all the oxygenated blood from the lungs was returned to the right heart through anomalous vessels. Thirty-five per cent of these cases of complete diversion were accompanied by other major cardiac defects. It is estimated that 50% or more of the return flow from the lungs must reach the right heart to produce clinical symptoms. Two cases are presented of persistence of the left superior vena cava which transmitted all the freshly oxygenated blood to the right auricle, by way of the left innominate and the right superior vena cava. The clinical picture was that of growth retardation, minimal cyanosis, a huge hyperactive heart, a loud left mesocardial systolic murmur, pulsating shadows in both upper pulmonary fields, and nearly identical oxygen-saturation of blood obtained from the right heart and femoral artery. One case is reported in which all the oxygenated blood from the lungs is carried to the right auricle by way of the ductus venosus. Surgical correction of the abnormality of these cases by transplantation of one or more of the veins would have been possible. However, no case known to the authors has yet been successfully corrected.

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.

TYPES OF CORRECTION OF THE SUPRACARDIAC FORM OF PARTIAL ABNORMAL DRAINAGE OF THE PULMONARY VEINS. WARDEN PROCEDURE

2021 ◽  
pp. 28-31
Author(s):  
Inkar Sagatov ◽  
Nurzhan Dosmailov
Keyword(s):  
Left Atrium ◽  
Superior Vena Cava ◽  
Right Atrium ◽  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Artificial Circulation ◽  
The Right

The article describes the types of correction of the supracardial form of abnormal drainage of the pulmonary veins. One of the methods of correcting this defect is the Warden operation, which includes: after sternotomy, connection of artificial circulation, cardioplegia, the superior vena cava is cut off, the proximal end is sutured. Next, a right atriotomy is performed, an anastomosis is formed using an autopericardial patch between the abnormal drainage and the left atrium through the ASD. Then an anastomosis is formed between the auricle of the right atrium and the distal end of the superior vena cava. As a result, blood from the abnormal pulmonary veins begins to drain into the left atrium through the ASD.

Cor Triatriatum in Association With a Unique Form of Partial Anomalous Pulmonary Venous Connection

2021 ◽  
pp. 215013512110469
Author(s):  
Lou Capecci ◽  
Richard D. Mainwaring ◽  
Inger Olson ◽  
Frank L. Hanley
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Venous Drainage ◽  
Cor Triatriatum ◽  
Unique Form ◽  
Elective Repair ◽  
The Right ◽  
Anomalous Pulmonary Venous Connection

Cor triatriatum may be associated with abnormalities of pulmonary venous anatomy. This case report describes a unique form of partial anomalous pulmonary venous connection. The patient presented at 5 weeks of age with symptoms of tachypnea and poor feeding. Echocardiography demonstrated cor triatriatum and partial anomalous pulmonary venous drainage of the right upper lung. The patient underwent urgent repair of cor triatriatum. It was elected to not address the partial anomalous pulmonary venous connection at that time. The patient returned at age 19 months for elective repair of the anomalous pulmonary venous connection. There was also a large vein connecting the right lower pulmonary veins to the superior vena cava. This was repaired by dividing the superior vena cava along a vertical axis to redirect the flow of the anomalous pulmonary veins through the connecting vein to the left atrium. This report describes the anatomy and surgical approach to a unique form of anomalous pulmonary venous connection.

scholarly journals Cardiac Lipoma - Case presentation

2021 ◽  
Vol 107 (05) ◽  
pp. 240-242
Author(s):  
Ása Unnur Bergmann ◽  
◽  
Helga Þórunn Óttarsdóttir ◽  
Björn Flygenring ◽  
Helgi Már Jónsson ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Right Atrium ◽  
Clinical Symptoms ◽  
Incidental Finding ◽  
Superior Vena ◽  
Vena Cava ◽  
Large Mass ◽  
Benign Tumors ◽  
Computed Tomographic ◽  
The Right

Cardiac lipomas are very rare benign tumors of the heart. They are usually asymptomatic and are often an incidental finding on cardiac imaging. This case report involves an 82-year-old female with a history of diabetes admitted because of poor glycemic control. An echocardiogram requested because of arrhythmias and heart failure revealed a tumor in the right atrium. Computed tomographic and ultrasound appearances were consistent with a lipoma and demonstrated a large mass in the right atrium, causing a significant stenosis of the superior vena cava but no clinical symptoms or signs of superior vena cava syndrome

Modified Warden Operation With the Use of Femoral Vein Homograft for Repair of a Variant of Right-Sided Partial Anomalous Pulmonary Venous Connection

2020 ◽  
Vol 11 (2) ◽  
pp. 217-219
Author(s):  
Josue Chery ◽  
Karthik Ramakrishnan ◽  
Russel Cross ◽  
Richard A. Jonas
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Femoral Vein ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Pulmonary Venous Obstruction ◽  
Anatomical Variant ◽  
Anomalous Pulmonary Venous Return ◽  
The Right ◽  
Anomalous Pulmonary Venous Connection

Surgical repair of right-sided partial anomalous pulmonary venous return (PAPVR) involves baffling the pulmonary vein across a naturally occurring or surgically created atrial septal defect without causing pulmonary venous or superior vena cava obstruction. A nine-year-old male presented to us with an unusual anatomical variant of right-sided partial anomalous pulmonary venous connection. The pulmonary veins draining the right upper and middle lobes connected to the azygous vein that drained in the usual fashion into the superior vena cava. The Warden operation was modified, with the use of femoral vein homograft, to avoid pulmonary venous obstruction.

ID: 5: ISOLATED SUPRA-CARDIAC PARTIAL ANOMALOUS PULMONARY VENOUS CONNECTION CAUSING RIGHT HEART FAILURE

2016 ◽  
Vol 64 (4) ◽  
pp. 918.2-919 ◽  
Author(s):  
R Sogomonian ◽  
H Alkhawam ◽  
S Lee ◽  
JJ Lieber ◽  
EA Moradoghli Haftevani
Keyword(s):  
Pulmonary Vein ◽  
Superior Vena Cava ◽  
Ventricular Hypertrophy ◽  
Superior Vena ◽  
Vena Cava ◽  
Right Heart Failure ◽  
Right Heart ◽  
Intact Atrial Septum ◽  
The Right ◽  
Anomalous Pulmonary Venous Connection

One of many causes of right heart failure (RHF) is partial anomalous pulmonary venous connection (PAPVC). We present a rare entity of isolated supra-cardiac PAPVC, as right pulmonary vein drains into the superior vena cava (SVC) with intact atrial septum, precipitating RHF.A 55-year-old man with hypertension, diabetes mellitus, coronary artery disease, presenting with syncope. On examination blood pressure was 90/44 mm Hg and heart rate of 44 bpm, lungs were clear on auscultation, jugular venous distension was present, prominent S2 heart sound, and bilateral pitting edema of the lower extremities. Laboratory studies were significant for brain natriuretic peptide (BNP) of 504 pg/mL, troponin I of 0.06 ng/mL, and glycated hemoglobin (HgA1c) of 11.9%. Electrocardiography was significant for left atrial dilation and right ventricular hypertrophy. Transthoracic echocardiography (TTE) showed severe right ventricular dilation, left ventricular hypertrophy, and severe tricuspic regurgitation with pulmonary artery systolic pressure of 85 mm Hg. Additionally, on the TTE ejection fraction was noted to be 55% with no evidence of atrial septal defect (ASD). Cardiac catheterization and computed tomography angiogram (CTA) revealed severe pulmonary hypertension and drainage of the right pulmonary vein into the superior vena cava.We have described a case of an isolated supra-cardiac variant of right pulmonary vein draining into the SVC. ASD is absent in isolated form of PAPVC, our case demonstrated an intact atrial septum in a supra-cardiac variant. Studies have indicated that 82% of patients with PAPVC have an ASD, distinguishing our case as an uncommon entity.Patient was discharged with optimized doses of bumetanide, metoprolol, and was offered surgery for the definitive treatment. Surgical prognosis is excellent and the perioperative mortality rate is less than 0.1%.Abstract ID: 5 Figure 1Cardiac catheterization illustrating drainage from the right pulmonary vein anomalously into the superior vena cava.

scholarly journals PERSISTENT LEFT SUPERIOR VENA CAVA: A DECEPTIVE ANOMALY

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Javaria Aleem ◽  
Waqas Ahmad
Keyword(s):  
Superior Vena Cava ◽  
Coronary Sinus ◽  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Central Venous Line ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
Vena Cava Superior ◽  
The Right

Persistent left superior vena cava (SVC) is a rare but vital congenital anomaly of the thoracic venous system. It is the persistence of vessel that normally regresses during early foetal life. It has utmost importance in intervention radiology, cardiothoracic procedures and insertion of the central venous line as well as in trauma. The vessel can drain into the right atrium through the coronary sinus, directly into left atrium or through pulmonary veins. It is usually detected during routine investigations and requires surgical treatment. In our case, SVC persists on both right and left sides with enlarged coronary sinus incidentally detected during follow-up for breast cancer.Key words: Persistent left superior vena cava, superior vena cava, vascular variant

scholarly journals Midline crossing pulmonary vein: right upper lobe dual venous drainage, with partial anomalous venous return of the right lung into a persistent left superior vena cava

2021 ◽  
Author(s):  
J. van Schuppen ◽  
A. E. van der Hulst ◽  
I. M. Kuipers ◽  
B. Straver ◽  
S. M. Boekholdt ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Vascular Anatomy ◽  
Disease Status ◽  
Venous Drainage ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
The Right

Abstract Introduction We present a case of dual drainage of the right upper lobe of the lung into the left atrium and via partial anomalous venous pulmonary return (PAPVR) into a persistent left superior vena cava (SVC). Discussion It is only in the minority of PAPVR cases where the anomalous pulmonary veins cross the midline. We provide a review of current literature on this topic and an explanatory embryological model. Knowledge of embryonic development and possible anatomic variations, including the concept of dual venous drainage of the lung, leads to better interpretation of imaging, with more accurate description of the morphology at hand. High-resolution multidetector computed tomography (MDCT) helps to delineate the exact vascular anatomy. This will enhance a better understanding of and anticipation on the patient’s disease status, with more accurate planning of intervention, and possibly less complications.

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