scholarly journals Delayed Diagnosis of Rare Cyanotic Cardiac Lesion in A Hypoxemic but otherwise Asymptomatic Infant

2020 ◽  
Vol 26 (2) ◽  
pp. 68-75
Author(s):  
Dayang Zuraini Sahadan ◽  
Ee Wei Ng ◽  
Yinn Khurn Ooi
Keyword(s):  
Superior Vena ◽  
Delayed Diagnosis ◽  
Vena Cava ◽  
Venous Drainage ◽  
Supplemental Oxygen ◽  
Systemic Embolization ◽  
Anomalous Systemic Venous Drainage ◽  
Long Term Prognosis ◽  
Asymptomatic Infant

The causes of neonatal hypoxemia are usually either pulmonary or cardiac pathologies. We report a case of a 2-month-old boy with oxygen dependency since birth. He would desaturate down to 88-90% whenever supplemental oxygen was weaned off. Initial screening echocardiograms described only a small atrial septal defect, thus lung disease was thought to be the aetiology. Eventually, a detailed echocardiogram and CT angiography revealed anomalous right superior vena cava (RSVC) draining into the left atrium (LA). Echocardiography with bubble study injected via the upper extremities showed brisk filling of “bubbles” in the left heart, confirming fixed right-to-left shunting. Anomalous RSVC drainage into the LA is an extremely rare form of anomalous systemic venous drainage whereby unexplained hypoxemia is present and is sometimes the only clinical manifestation. Surgical correction of this anomaly is indicated to prevent complications of cyanosis and risk of systemic embolization. The surgery generally carries low risk and is associated with good long-term prognosis.

Partial Anomalous Pulmonary Venous Connection: Forty-Six Years of Follow-Up

2021 ◽  
Vol 12 (1) ◽  
pp. 70-75
Author(s):  
Anne Kathrine M. Nielsen ◽  
Vibeke E. Hjortdal
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Sinus Node ◽  
Vena Cava ◽  
Node Disease ◽  
Sinus Node Disease ◽  
Patch Technique ◽  
Anomalous Pulmonary Venous Connection

Background: Surgical repair of partial anomalous pulmonary venous connection (PAPVC) may disturb the electrical conduction in the atria. This study documents long-term outcomes, including the late occurrence of atrial tachyarrhythmia and bradyarrhythmia. Methods: This retrospective study covers all PAPVC operations at Aarhus University Hospital between 1970 and 2010. Outcome measures were arrhythmias, sinus node disease, pacemaker implantation, pathway stenosis (pulmonary vein(s), intra-atrial pathway, and/or superior vena cava), and mortality. Data were collected from databases, surgical protocols, and hospital records until May 2018. Results: A total of 83 patients were included with a postoperative follow-up period up to 46 years. Average age at follow-up was 43 ± 21 years. During follow-up, new-onset atrial fibrillation or atrial flutter appeared in four patients (5%). Sinus node disease was present in nine patients (11%). A permanent pacemaker was implanted in seven patients (8%) at an average of 12.7 years after surgery. Pulmonary venous and/or superior vena cava obstruction was seen in five patients (6%). Stenosis was most prevalent in the two-patch technique, and arrhythmia was most prevalent in the single-patch technique. Sixty-seven (81%) of 83 patients had neither bradyarrhythmias nor tachyarrhythmias or pacemaker need. Conclusions: This study contributes important long-term data concerning the course of patients who have undergone repair of PAPVC. It confirms that PAPVC can be operated with low postoperative morbidity. However, late-onset stenosis, bradyarrhythmias and tachyarrhythmias, and need for pacemaker call for continued follow-up.

Effect of hypoxic hypoxia on systemic vasculature

1984 ◽  
Vol 56 (5) ◽  
pp. 1403-1410 ◽  
Author(s):  
J. Malo ◽  
H. Goldberg ◽  
R. Graham ◽  
H. Unruh ◽  
C. Skoog
Keyword(s):  
Arterial Pressure ◽  
Inferior Vena ◽  
Superior Vena ◽  
Venous Pressure ◽  
Vena Cava ◽  
Venous Drainage ◽  
Hypoxic Hypoxia ◽  
Venous Compliance ◽  
Flow Curves ◽  
Pressure Flow

Effects of hypoxic hypoxia (HH) on cardiac output (CO), CO distribution, arterial and venous pressure-flow curves, vascular compliance, vascular time constant (tau), and resistance to venous return (RVR) were evaluated on six dogs. The vascular bed was isolated into four compartments depending on venous drainage: superior vena cava (SVC), splanchnic, renal and adrenal, and the remainder of the inferior vena cava (IVC). Low arterial O2 content and PO2 produced a threefold increase in CO at the same mean arterial pressure and a significant redistribution of CO to the SVC. Arterial pressure-flow curves decreased their slope (i.e., flow resistance) by a factor of two in the IVC and renal beds and by a factor of three in the splanchnic and SVC beds. Venous pressure-flow curves for the animal also decreased their slope significantly. HH causes a twofold increase in venous compliance and in mean venous pressure; tau did not change, but RVR halved. Seventy percent of the CO increase is explained by the increase in mean venous pressure and 30% by the reduction in RVR.

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.

New alternative approach in case of pacemaker-dependent patient with bilateral pocket infection and persistent superior vena cava (or venous drainage abnormality)

2017 ◽  
Vol 3 (44) ◽  
pp. 22-24
Author(s):  
Piotr Szafarz ◽  
Janusz Romanek ◽  
Marcin Chlebuś ◽  
Andrzej Przybylski
Keyword(s):  
Technological Development ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Drainage ◽  
Upper Body ◽  
Difficult Situation ◽  
Right Ventricular Pacing ◽  
Alternative Approach ◽  
Pocket Infection ◽  
Dependent Patient

This paper describes the case of pacemaker-depandent male patient with upper body venous dreinage anomaly, who suffered from bilateral pocket infection. This difficult situation made it impossible to implant the device in the subclavian region and forced us to search for an alternative access for right ventricular pacing. Presented case describes new possibilities in electrotherapy which are provided by technological development and miniaturization of medical devieces.

The Different Impacts on the Long-Term Survival of Tunneled Internal Jugular Hemodialysis Catheters Based on Tip Position and Laterality

2017 ◽  
Vol 43 (4) ◽  
pp. 315-320 ◽  
Author(s):  
Vedran Premuzic ◽  
Drazen Perkov ◽  
Ranko Smiljanic ◽  
Bruna Brunetta Gavranic ◽  
Bojan Jelakovic
Keyword(s):  
Superior Vena ◽  
Vena Cava ◽  
The Body ◽  
Term Survival ◽  
Catheter Tip ◽  
Tip Position ◽  
The Impact

Background/Aims: The aim of this study was to examine the impact of different catheter tip positions on the life of the catheter, dysfunction, infection, and quality of hemodialysis and possible differences between the access site laterality in jugular-tunneled hemodialysis catheters. Methods: Catheters were evaluated for the following parameters: place of insertion, time of insertion, duration of use, and reason for removal. In all patients, the catheter tip position was checked using an X-ray. Results: The mean duration of implanted catheters with the tip placed in the cavo-atrial junction and right atrium was significantly longer. There were no differences in catheter functionality at follow-up or complications based on catheter laterality for each catheter tip position. Conclusion: According to our results, the localization of the catheter tip in superior vena cava still remains the least preferable method. Our results showed that the main factor responsible for better catheter functionality was not laterality but the depth to which the catheter tip is inserted into the body.

scholarly journals Upper vena cava syndrome secondary to giant atrial myxoma

2018 ◽  
Vol 64 (12) ◽  
pp. 1077-1080 ◽  
Author(s):  
Flávia Contreira Longatto ◽  
Thamires Suellen Alves Pereira Santos ◽  
Marília Joaquina de Medeiros Soares ◽  
Juliana Negrisoli ◽  
Tatiana de Carvalho Andreucci Torres Leal ◽  
...  
Keyword(s):  
Present Report ◽  
Superior Vena ◽  
Cardiac Myxoma ◽  
Vena Cava ◽  
Benign Neoplasm ◽  
Atrial Myxoma ◽  
Right Atrial ◽  
Systemic Embolization ◽  
Hepatic Congestion ◽  
Vena Cava Syndrome

SUMMARY Cardiac myxoma is a benign neoplasm, which corresponds to the most common primary heart tumour, responsible for about 50% of the cases. In general, 75-80% of myxomas are located in the left atrium, 18% in the right atrium, and more rarely in the ventricles or multicentric. Right atrial myxoma, in particular, can obstruct the tricuspid valve, causing symptoms of right heart failure, peripheral oedema, hepatic congestion, and syncope. Systemic embolization occurs in 30% of cases, by either tumour fragmentation or total tumour detachment. In the present report, we present a case of a symptomatic patient, who showed a large right intra-atrial lesion, with consequent superior vena cava syndrome, and then underwent surgical resection at admission.

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