Repair of the partial anomalous pulmonary venous connection to the superior vena cava in children - Direct anastomosis of the superior vena cava to the right atrial appendage.

The cardiomyocytes in the superior vena cava (SVC) myocardial sleeve have distinct action potentials and ionic current profiles, but the refractoriness of these cells has not been reported. Using standard intracellular microelectrode techniques, we demonstrated in sheep that the effective refractory period (ERP) of the cardiomyocytes in the SVC (114.7 ± 6.5 ms) is shorter than that in the inferior vena cava (IVC) (166.7 ± 6.2 ms), right atrial free wall (RAFW) (201.0 ± 6.0 ms) and right atrial appendage (RAA) (203.1 ± 5.8 ms) ( P < 0.05). The right atrial cardiomyocyte ERP was heterogeneously shortened by acetylcholine, a muscarinic type 2 receptor (M2R) agonist. After perfusion with 15 μM acetylcholine, the shortest ERP occurred in the SVC (the ERP in the SVC, IVC, RAFW and RAA was 53.6 ± 2.7, 98.9 ± 2.2, 121.8 ± 6.0 and 109.7 ± 5.1 ms, respectively; P < 0.05). Carbachol (1 μM), another M2R agonist, produced a similar effect as acetylcholine. Furthermore, we used methoctramine, a M2R blocker, 4-DAMP, a muscarinic type 3 receptor (M3R) blocker, and tropicamide, a muscarinic type 4 receptor (M4R) blocker to inhibit the acetylcholine-induced ERP shortening of SVC cardiomyocytes, and found that the 50% inhibitory concentration for methoctramine, 4-DAMP and tropicamide was 5.91, 45.72 and 80.34 nM, respectively. Therefore, we conclude that the sheep SVC myocardial sleeve is a unique electrophysiological region of the right atrium with the shortest ERP both under physiological condition and under cholinergic agonist stimulation. M2R might play a major role in the response of the SVC myocardial sleeve to parasympathetic nerve tone. The association between the distinct refractoriness in SVC and atrial fibrillation originating from the region deserves further investigation.

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P35 Innominate Vein to Right Atrial Appendage Bypass for Superior Vena Cava Syndrome – Technique and Pitfalls

Heart Lung and Circulation ◽

10.1016/j.hlc.2021.03.238 ◽

2021 ◽

Vol 30 ◽

pp. S45

Author(s):

J. Tesar ◽

J. Varzaly ◽

C. Cole ◽

M. Ura

Keyword(s):

Superior Vena Cava ◽

Superior Vena Cava Syndrome ◽

Superior Vena ◽

Vena Cava ◽

Innominate Vein ◽

Atrial Appendage ◽

Right Atrial ◽

Vena Cava Syndrome ◽

Right Atrial Appendage

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Bifid apex, persistent left superior vena cava, muscularised coronary sinus, bare atrioventricular cleft, bilateral hepatocardiac channels and bull’s horns in the right atrial appendage: Congenital defects possibly due to phylogenic downgrading of genes

Indian Journal of Thoracic and Cardiovascular Surgery ◽

10.1007/s12055-003-0014-3 ◽

2003 ◽

Vol 19 (4) ◽

pp. 178-183 ◽

Cited By ~ 2

Author(s):

S Victor ◽

VM Nayak

Keyword(s):

Superior Vena Cava ◽

Coronary Sinus ◽

Superior Vena ◽

Vena Cava ◽

Right Atrial ◽

Congenital Defects ◽

Left Superior Vena Cava ◽

Persistent Left Superior Vena ◽

Right Atrial Appendage ◽

The Right

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

10.36811/jcshd.2022.110023 ◽

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

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

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/21501351211046907 ◽

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.

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