scholarly journals Chiari Network in Patient with Interatrial Septal Defect and Pulmonary Hypertension

2020 ◽  
Vol 27 (2) ◽  
pp. E202027
Author(s):  
Olha Manetska ◽  
Inna Tarchenko
Keyword(s):  
Pulmonary Hypertension ◽  
Inferior Vena Cava ◽  
Right Atrium ◽  
Septal Defect ◽  
Inferior Vena ◽  
Vena Cava ◽  
The Other ◽  
Chiari Network ◽  
The Right ◽  
Different Parts

Chiari network is a moving fibrous mesh-like structure that is visualized in 2% of cases in the right atrium. It is attached on one side to the valve of the inferior vena cava and on the other to different parts of the right atrium. In most cases this structure has no clinical significance and may be an accidental finding during echo- imaging. But sometimes it can be a source of thrombosis and in the future – the cause of thromboembolism, or, conversely, be an obstacle to the movement of thrombus.

Venous drainage for minithoracotomy approach in an adult with interrupted inferior vena cava

2021 ◽  
pp. 021849232110170
Author(s):  
Toshitaka Watanabe ◽  
Kazuma Okamoto ◽  
Nobuyuki Yoshitani ◽  
Ryo Tohma ◽  
Takuya Misato ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Right Atrium ◽  
Septal Defect ◽  
Inferior Vena ◽  
Femoral Vein ◽  
Vena Cava ◽  
Venous Drainage ◽  
Preoperative Imaging ◽  
Atrial Septal Defect Closure ◽  
The Right

For atrial septal defect closure via right minithoracotomy in an adult patient with infra-hepatic interruption of the inferior vena cava with azygos connection, an alternative venous cannulation strategy was applied. In addition to bicaval cannulations to the femoral vein and the internal jugular vein, a 20 Fr straight cannula draining the hepatic vein was added to the proximal IVC through the right atrium wall via a working port. A bloodless operative field in the right atrium was afforded with bicaval encircling. Preoperative imaging test of the continuity of the IVC was important planning cardiac surgery with peripheral cannulations.

scholarly journals Radioechocardiography in the evaluation of pulmonary hypertension

2016 ◽  
Vol 97 (6) ◽  
pp. 982-988
Author(s):  
R F Akberov ◽  
S R Zogot ◽  
N A Tsibul’kin
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Inferior Vena Cava ◽  
Digital Radiography ◽  
Right Atrium ◽  
Inferior Vena ◽  
Vena Cava ◽  
Lower Limbs ◽  
The Right

Aim. To study the capabilities of radioechocardigraphy in the evaluation of pulmonary hypertension of various causes, early non-invasive detection of pressure increase in the pulmonary artery.Methods. The study included 800 patients with congenital (269) and acquired (217) mitral valve diseases, pulmonary embolism (140), primary pulmonary hypertension (57), coronary heart disease with acute myocardial infarction (117) of different age and gender. Digital radiography, linear tomography of chest, ECG, echocardiography, multidetector computed tomography angiography, and ultrasound of inferior vena cava were performed.Results. Radiocardiography combined with linear tomography and measurement of Moore index, right atrium index, transpulmonary distance, and width of right descending pulmonary artery at the level of intermediate bronchus, allows determining the degree, type (arterial, venous, capillary, and mixed) and cause of pulmonary hypertension. Digital radiography and linear tomography in 80% cases reveal signs of pulmonary embolism. Echocardiography makes it possible to study hemodynamics in pulmonary hypertension, to detect the dilation of the right heart, inferior vena cava, and renal veins, and to calculate the systolic pressure in the right ventricle, pulmonary artery, and right atrium. Radioechocardigraphy allows determining the cause and degree of pulmonary hypertension, and hemodynamic disorders. Sensitivity of the method for diagnosis of pulmonary hypertension is 89%, specificity is 90%, and precision is 92%.Conclusion. Radioechocardigraphy is a highly effective method for diagnosis of pulmonary hypertension; ultrasound of inferior vena cava, iliac veins, and veins of the lower limbs allows to determine the source of pulmonary embolism, to diagnose embologenicity of thromboses and to evaluate the need for vena cava filters.

scholarly journals P718 Unexpected finding during follow up for a suspected arrythmogenic right ventricular cardiomyopathy (ARVC)

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Castellanos Alcalde ◽  
N Garcia Ibarrondo ◽  
G Ramirez-Escudero ◽  
R Candina Urizar ◽  
A Lanbarri Izaguirre ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Right Atrium ◽  
Septal Defect ◽  
Inferior Vena ◽  
Vena Cava ◽  
Interatrial Communication ◽  
The Right

Abstract Interatrial communication is the most common congenital defect found in adulthood, being the most common ostium secundum variety (70-80%). Superior and inferior sinus venosus defects are less usual, found in the 5-10% of cases of interatrial communication and frequently associated with anomalous pulmonary venous return (APVR). These defects are located near the junction of the superior (5%) or inferior (<1%) vena cava with the right atrium, which makes them difficult to diagnose by transthoracic ecocardiography (TTE). Case description: A 44-year-old man who is being followed up in our electrophysiology consulting with suspicion of ARVC (suggestive CMR with no gene found) after an episode of ventricular tachycardia (VT) 11 years ago. Asymptomatic since then under treatment with atenolol, except for an episode of chest pain that required a coronary computed tomography which described an image compatible with a patent foramen ovale and normal coronary arteries. During the follow-up a cardio magnetic resonance (CMR) is performed which showed a severely dilated right ventricle with diskinetic areas, no volume changes since last CMR (5 years ago) and preserved ejection fraction. A small interatrial communication located infero-posteriorly in the septum drawed our attention. Estimated QP/QS was 1.4. After this finding, we reviewed the CT made 4 years ago, where a flow from the left atrium to the right atrium could be seen. We decided to ask for both a transthoracic echocardiography (TTE) and a transesophageal echocardiography (TEE). TTE showed normal left ventricle, a dilated right ventricle with preserved function, no valvulopathies and normal pulmonary pressure. Shunt test with agitated saline was slightly positive after Valsalva maneuver, and QP/QS was again 1.4. TTE showed a small interatrial communication measuring 1.9x0.8cm, next to inferior vena cava`s drainage. Since right ventricle dilation could be due both to the atrial septal defect (ASD) and to the dysplasia, the case was discussed in the heart team, and as the defect was small, QP/QS was 1.4 and pulmonary pressure was normal we adopted a conservative approach. Inferior sinus venosus defects are one of the least common atrial septal defects. They are located in the atrial septum immediately above the orifice of the inferior vena cava and are often associated with partial anomalous connection of the right pulmonary veins. This location makes it difficult to see by means of a common TTE or TEE, and usually as in our case multimodal approach can be very helpful. Usually patients with this kind of atrial septal defect (ASD), signs of significant shunt (right ventricular volume overload, QP/QS≥1.5) and systolic PA pressure less than 50% of systemic pressure (with pulmonary vascular resistance less than one third of the systemic vascular resistance) are suggested for surgery. In this case the possibility of two pathologies overlapping makes it challenging for diagnosis and treatment. Abstract P718 Figure. Multimodal imaging for diagnosis.

scholarly journals P1246 The Eustachian valve: a structure not so innocent

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
T E Graca Rodrigues ◽  
R Placido ◽  
C David ◽  
S Goncalves ◽  
F J Pinto ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Inferior Vena Cava ◽  
Atrial Septal Defect ◽  
Right Atrium ◽  
Septal Defect ◽  
Inferior Vena ◽  
Vena Cava ◽  
Eustachian Valve ◽  
The Right

Abstract Background The eustachian valve is an embryological remnant of the inferior vena cava (IVC) valve. It is usually absent or inconspicuous and has no known function in the normal adult. However, there are reports suggesting that the EV is not as innocent as we thought. The EV can be a site of infective vegetations or be mistaken for a thrombus or tumor. The EV can also make interventional procedures (closure of ASD (atrial septal defect) or ablation for atrial flutter) more laborious. Clinical Case A 80 year-old female patient was referred to the emergency department after an episode of acute palpitations, right chest pain, followed by syncope. She had a previous medical history of type 2 diabetes and epilepsy. On admission she was normotensive (104/67mmHg). The ECG showed atrial fibrillation with heart rate of 180 beats per minute. The echocardiogram show slight dilation of the right ventricle and bilateral atrial dilatation. The blood tests documented an elevated D-dimers 2,73 μg/mL, troponin (hs-TNT 27ng/L) and NT-proBNP 4339pg/ml, with a normal renal function. Computed tomographic (CT) pulmonary angiography revealed filling defects on the segmentar and subsegmentar inferior lobes, compatible with the diagnosis of pulmonary embolism and also revealed a dilatation of the main pulmonary trunk (35mm). Based on this result the patient start anticoagulation with low molecular weight heparin and heart rate control with bisoprolol. However besides of this strategy the patient remain in atrial fibrillation without a controlled hear rate and an transesophageal echocardiography (TOE) was performed. The TOE shown a small freely mobile mass – thombi - at the inferior vena cava-right atrium (IVC-RA) junction tethered at the eustachian valve; a small atrial septal defect (4mm) – ostium secundum type – with a left to right shunt; and a preserved biventricular function (figure 1). Based on this exams we optimize the therapy with digoxin and amiodarone with a good control of the heart rate and patient was discharge on warfarine, bisoprolol and digoxin asymptomatic and to be reevaluated on cardiology clinic. Discussion/Conclusion: The eustachian valve in adult is an embryological remainder of the fetal venous sinus valve. This structure is located in the right atrium and is a common, not pathological, echocardiographic finding. It is known that a small percentage of the pulmonary embolisms, thrombi are discovered in the right side of the heart; however, their presence on the Eustachian valve is very unusual. Besides this in our particular case in the present we will have also to ensure that the anticoagulation is effective to avoid that the trombi migrates into the systemic circulation by the atrial septal defect. Abstract P1246 Figure.

scholarly journals Advanced Hepatocellular Carcinoma with Subtotal Occlusion of the Inferior Vena Cava and a Right Atrial Mass

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Christian Steinberg ◽  
Suzanne Boudreau ◽  
Felix Leveille ◽  
Marc Lamothe ◽  
Patrick Chagnon ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Inferior Vena Cava ◽  
Right Atrium ◽  
Inferior Vena ◽  
Vena Cava ◽  
Great Majority ◽  
Right Atrial ◽  
Advanced Hepatocellular Carcinoma ◽  
Regional Lymph Nodes ◽  
The Right

Hepatocellular carcinoma usually metastasizes to regional lymph nodes, lung, and bones but can rarely invade the inferior vena cava with intravascular extension to the right atrium. We present the case of a 75-year-old man who was admitted for generalized oedema and was found to have advanced HCC with invasion of the inferior vena cava and endovascular extension to the right atrium. In contrast to the great majority of hepatocellular carcinoma, which usually develops on the basis of liver cirrhosis due to identifiable risk factors, none of those factors were present in our patient.

scholarly journals Transarterial Radioembolization Treatment of Advanced Hepatocellular Carcinoma Invading the Right Atrium

2021 ◽  
pp. 1-4
Author(s):  
Kabalane Yammine ◽  
◽  
Sarah Khalife ◽  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Inferior Vena Cava ◽  
Right Atrium ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Vena Cava ◽  
Treatment Strategies ◽  
Complete Response ◽  
Advanced Hepatocellular Carcinoma ◽  
The Right

Tumor thrombus infiltration of hepatocellular carcinoma (HCC) into the inferior vena cava and right atrium is rare and is associated with a poor prognosis due to the critical location of the tumor and the limited efficiency of the available treatment strategies. In this study, we report the case of a patient with advanced HCC and tumor thrombus in the inferior vena cava and right atrium who demonstrated complete response with mass retraction upon Yttrium-90 trans-arterial radioembolization (90Y- TARE) therapy. Throughout the 16 months follow-ups after the radioembolization, the patient was free of any complications, revealing no occurrence of radiation-induced pneumonitis or tumor recurrence.

scholarly journals P169 Uterine leiomyoma extension into right side cardiac

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Diniz Ferrer ◽  
CARLOS Silveira ◽  
ADRIAN Reis ◽  
PAULA Abreu E Lima ◽  
ROBERT Diniz ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Right Atrium ◽  
Uterine Leiomyoma ◽  
Inferior Vena ◽  
Tumor Resection ◽  
Vena Cava ◽  
Cardiac Imaging Techniques ◽  
First Case ◽  
Adjacent Structures ◽  
The Right

Abstract Funding Acknowledgements governmental grants Uterine leiomyoma is a commom disease in women, however, intravenous leiomyomatosis of uterine origin extending via inferior vena cava into the right side of the heart,known as intracardiac leiomyomatosis is a rare condition (3%). In 1907, Durk reported the first case of intracardiac extension. The patient was a Woman, 35 years old, admitted to our emergency department for an intracardiac mass. She had shortness of breath,fatigue and chest pain. The transthoracic two dimensional echocardiography showed an echogenic oval mass mobile in right atrium and projected through right ventricle in diastole. This mass was observed to extend from inferior vena cava to the right atrium. The echotransesophageal three dimensional showed a large mobile mass that extended from inferior vena cava to the right atrium. A Computer tomographic (CT) scan showed a hypodense multilobulated mass in the pelvis, which had invaded the inferior vena cava and right atrium. The patient underwent a two stages surgery. In first stage (transatrial tumor resection). The operation was performed normal temperature with establisment of cardiopulmonary bypass (CPB). Subsequently, the pathological report was confirmed uterin smooth muscle origin. The second stage surgery ( total histerectomy) was done four weeks later for removing lobulated mass uterin with dimensions 20x15x7.5cm with confirmed histopathological of leiomyoma. Because of it is nonspecific clinical presentation and rarity, an intracardiac Leiomyomatosis continues to be a misdiagnosed as either thrombus or myxoma. The cardiac imaging techniques like a transthoracic echocardiography 2d and transesophageal echocardiography 3d have been used to define the presence, extension of tumor as appearance of the mass and involvement of adjacent structures. Abstract P169 Figure. Echotransesophageal 3D (bicaval view)

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