scholarly journals A patient with atrial septal defect with cyanosis with diagnostic dilemma turned out to be a case of Total Anomalous Pulmonary Venous Connection (TAPVC)

KYAMC Journal ◽  
2021 ◽  
Vol 12 (2) ◽  
pp. 107-110
Author(s):  
Mahbub Ahsan ◽  
Md Lutfar Rahman ◽  
ASM shariful Islam ◽  
Prokash Chandra Munshi ◽  
Md Muzibur Rahman ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Heart Surgery ◽  
Septal Defect ◽  
Pulmonary Veins ◽  
Open Heart Surgery ◽  
Hepatic Veins ◽  
Diagnostic Dilemma ◽  
Ct Angiogram ◽  
Congenital Cyanotic Heart Disease ◽  
Anomalous Pulmonary Venous Connection

Total anomalous pulmonary venous connection (TAPVC) is a congenital cyanotic heart disease where all 4 pulmonary veins do not open directly to left atrium. There are 4 types of TAPVC. Supra cardiac type forms a confluence and may open to Innominate vein or SVC. Cardiac type usually opens to coronary sinus. Infracardiac type opens to hepatic veins or other veins. Mixed type is the combination of others. Of these 4 types infracardiac type is most vulnerable and presents with early features of cyanosis, pulmonary hypertension, pulmonary vein obstruction. We present the case of an 18 year old lady with atrial septal defect (ASD) with cyanosis. Pre operative echo showed ASD with 3rd chamber behind LA, CT angiogram revealed large ASD, with tongue like extended chamber in posteromedial aspect of RA. Preoperative angiogram report was inconclusive. Despite the diagnostic dilemma, we took the challenge and the patient went for open heart surgery. The patient recovered well and discharged on 10 th post operative day. Post operative echocardiogram is encouraging and she is doing fine. KYAMC Journal.2021;12(02): 107-110

Surgical repair of total anomalous pulmonary venous connection: Lateral approach

2021 ◽  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Atrial Septal Defect ◽  
Left Atrium ◽  
Septal Defect ◽  
Surgical Repair ◽  
Pleural Cavity ◽  
Pulmonary Veins ◽  
Lateral Approach ◽  
The Right ◽  
Anomalous Pulmonary Venous Connection

We describe the lateral approach to the surgical repair of a total anomalous pulmonary venous connection in this video tutorial. The goal of the operation is to create an unobstructed anastomosis between the pulmonary confluence and the left atrium, ligate the systemic venous connections, and close the atrial septal defect. After a median sternotomy and initial dissection of the structures surrounding the heart, cardiopulmonary bypass is initiated by aortobicaval cannulation. The patient is then cooled to attain mild hypothermia (30°C). The heart is arrested by a dose of antegrade cold cardioplegia. The right pleural cavity is opened widely. The heart is retracted and pushed into the right pleural cavity. The vertical vein is ligated near its connection with the innominate vein. An incision is made along the length of the confluence, stopping short of the individual pulmonary veins. The left atrial appendage is retracted, and the left atrium is opened in alignment with the opening in the confluence. The left atrium and the pulmonary confluence are anastomosed widely with 7-0 polypropylene suture material. The heart is put back into the mediastinum. Rewarming is started. The atrial septal defect is closed through the right atrium using a large untreated autologous pericardium patch. The patient is then weaned off cardiopulmonary bypass.

scholarly journals Cor Triatriatum Dexter and Atrial Septal Defect in a 43-Year-Old Woman

2014 ◽  
Vol 41 (4) ◽  
pp. 418-420 ◽  
Author(s):  
Petar M. Vukovic ◽  
Dragana Kosevic ◽  
Miroslav Milicic ◽  
Ljiljana Jovovic ◽  
Ivan Stojanovic ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Heart Surgery ◽  
Septal Defect ◽  
Open Heart Surgery ◽  
Percutaneous Treatment ◽  
Cor Triatriatum ◽  
First Choice ◽  
Cor Triatriatum Dexter ◽  
The Right ◽  
Congenital Heart Anomaly

Cor triatriatum dexter is a rare congenital heart anomaly in which a membrane divides the right atrium into 2 chambers. We report the case of a 43-year-old woman who had cor triatriatum dexter and a large atrial septal defect. During attempted percutaneous closure, the balloon disrupted the membrane and revealed that the defect had no inferior rim, precluding secure placement of an Amplatzer Septal Occluder. Surgical treatment subsequently proved to be successful. In patients with an incomplete membrane and a septal defect with well-defined rims, percutaneous treatment can be the first choice. In patients who have cor triatriatum dexter and unfavorable anatomic features or concomitant complex heart anomalies, open-heart surgery remains the gold standard for treatment.

scholarly journals Atrial Septal Stenting - A Lifesaving Procedure: First Case Report from Bangladesh

2020 ◽  
Vol 13 (1) ◽  
pp. 86-91
Author(s):  
Naharuma Aive Hyder Chowdhury ◽  
Tawfiq Shahriar Haq ◽  
Mohammad Sharifuzzaman
Keyword(s):  
Heart Surgery ◽  
Septal Defect ◽  
Heart Defects ◽  
Pulmonary Veins ◽  
Open Heart Surgery ◽  
Palliative Procedure ◽  
First Case ◽  
Anomalous Pulmonary Venous Return ◽  
Systemic Oxygen ◽  
Asd Closure

Certain congenital heart defects require the creation of an unrestrictive atrial septal defect (ASD) secundum to achieve adequate atrial mixing to improve systemic oxygen saturation by placing septal stent. We reported a case of 7-month-old child who was presented with shock like state with marked desaturation. He was diagnosed as a case of mixed total anomalous pulmonary venous return with restricted closing ASD secundum. We performed atrial septal stenting as a palliative procedure for saving the life. Creation or enlargement of ASD in infants using nonconventional transcatheter techniques is feasible, safe, and effective when usual technique fails or not suitable. After the procedure systemic saturation improved and patient became hemodynamically stable and there after rerouting of pulmonary veins to left atrium with ASD closure and removal of stent done by open heart surgery and send him home safely. Cardiovasc. j. 2020; 13(1): 86-91

scholarly journals Outcome of Surgical Closure of Atrial Septal Defect in Sulaimani City

2020 ◽  
Author(s):  
Aso Faeq Salih ◽  
Hakam Marwan Mhadi ◽  
Shkar Raeof
Keyword(s):  
Atrial Septal Defect ◽  
Heart Surgery ◽  
Septal Defect ◽  
Open Heart Surgery ◽  
Age Group ◽  
Open Heart ◽  
Group 13 ◽  
Surgical Closure ◽  
Septal Defects ◽  
Atrial Septal Defects

An atrial septal defect (ASD), sometimes called a hole in the heart is a type of congenital heart defect in which there is an abnormal opening in the dividing wall between the upper filling chambers of the heart (the atria). To determine the outcome of surgical closure in patients with atrial septal defects, we designed a retrospective study, including 120 patients present with an atrial septal defect after surgical closure done in the cardiac teaching center in Sulaimani city. The data collected include the patients that admitted which are known cases of ASD and treated by open heart surgery during the last nine years from 1st of January 2008 until the 1st of January 2018. A total of 120 children diagnosed with Atrial Septal Defect (ASD) were included in this study with a mean age of 7.8±4.4 years; 32.5% of them were 1-5 years old, 50.8% of them were in the age group 6-12 years, and 16.7% of them were in the age group 13-19 years. Only three ASD children received medical treatment while all of them were treated surgically with open-heart surgery. The mean age of ASD children at surgery was7.8±4.4 years; 5.8% of them were 1-2 years old, 28.4% of them were 3-5 years old, 49.1% of them were in the age group 6-12 years, and 16.7% of them were in the age group 13-19 years. There was a significant association between primum ASD type and large ASD with posteroinferior deficient rims (P=0.04). A significant association was observed between primum ASD type and large IAS (P=0.006). Mean ASD diameter was significantly higher among patients with primum ASD type (P=0.01). The outcome of surgical closure of the atrial septal defect in children is effective and safe. Ventricular arrhythmia in the form of ectopic was the postoperative complication in one patient. The main echocardiography findings of children with atrial septal defects were large ASD with posteroinferior deficient rims.

Static balloon atrial septostomy for the purpose of left heart intervention in postoperative adult CHD

2018 ◽  
Vol 28 (10) ◽  
pp. 1116-1121
Author(s):  
Takanari Fujii ◽  
Hideshi Tomita ◽  
Yoshihito Hata ◽  
Takeshi Sasaki ◽  
Dai Asada ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Pulmonary Vein ◽  
Heart Surgery ◽  
Septal Defect ◽  
Open Heart Surgery ◽  
Interatrial Septum ◽  
Left Heart ◽  
Balloon Atrial Septostomy ◽  
Atrial Septostomy ◽  
Iatrogenic Atrial Septal Defect

AbstractBackground and purposeStatic balloon atrial septostomy is a widely accepted intervention for children with CHD. Successful surgical palliation is creating increasing numbers of adult CHD patients who need subsequent left heart intervention requiring transseptal access. In these patients, the interatrial septum is usually thick and fibrotic because of a previous open heart surgery or catheter intervention, and conventional transseptal puncture may be unsuccessful. Static balloon atrial septostomy to access the left atrium may facilitate intervention via the interatrial septum in such situations. The purpose of this study was to investigate the usefulness and the safety of static balloon atrial septostomy, and the evolution of an iatrogenic atrial septal defect post procedure in adult CHD.MethodsWe retrospectively reviewed six procedures in five adults with CHD and collected demographic characteristics, details of the procedures, clinical outcome, and size changes of the iatrogenic atrial septal defect.ResultsThe mean age at the time of the procedure was 35 years. The intended primary interventions were pulmonary vein isolation, stenting for pulmonary vein obstruction, and catheter ablation for focal atrial tachycardia. All static balloon atrial septostomies were effective, and the left heart interventions were successfully achieved via transseptal sheaths. There were no major complications associated with the static balloon atrial septostomy. There were no adverse clinical outcomes related to iatrogenic atrial septal defect, and the size of the defects regressed over time in all cases.ConclusionsStatic balloon atrial septostomy can be a safe and useful technique in adult CHD patients needing left heart procedures. The thick interatrial septum found in postoperative patients may reduce the risk of persistent iatrogenic atrial septal defect.

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