Persistent left vertical vein: An unusual cause of pulmonary hypertension and cirrhosis in a patient with hypertrophic obstructive cardiomyopathy

AbstractBackgroundA patent vertical vein might be desirable in patients with obstructive totally anomalous pulmonary venous connection with pulmonary hypertension, in order to decrease perioperative pulmonary arterial pressure and avoid pulmonary hypertensive crises. A subset of patients with an unligated vertical vein requires interruption of the vein due to the development of significant left-to-right shunt and right heart failure. We describe here a new device, permitting adjustable ligation of the vertical vein, which permits us to avoid multiple reoperations.Patients and methodsIn five patients, aged 2, 4, 3, 4, and 3 months respectively, and undergoing rechannelling of totally anomalous pulmonary venous connection with an unligated vertical vein, were treated with a device permitting adjusted ligation of the vertical vein over the course of postoperative congestive cardiac failure.ResultsThere was no early or late death. Postoperatively, all ligatures were tightened gradually over a period of 24 to 96 hours, maintaining stable haemodynamics. At a mean follow-up of 55.40 months, there was no evidence of congestive heart failure in any patient, the clinical risk score varying from zero to 2, and no requirement of anti-failure medications. Computed tomographic angiograms during follow-up revealed absence of flow through the vertical vein, and ruled out distortion of the left upper pulmonary and left brachiocephalic veins.ConclusionUse of a percutaneously adjustable device to ligate the vertical vein allows gradual tightening or loosening of the ligature under optimal physiologic conditions, without re-opening the sternum, or having to resort to another thoracotomy once the reactive components of pulmonary hypertension disappear.

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Pulmonary Hypertension Caused by Persistent Anomalous Vertical Vein Bridging the Left Subclavian Vein and Left Atrium With Hypertrophic Cardiomyopathy

Circulation ◽

10.1161/circulationaha.114.007639 ◽

2014 ◽

Vol 130 (18) ◽

Author(s):

Sonoko Maemura ◽

Masato Ishizuka ◽

Ryo Nakata ◽

Yoshihiro Motozawa ◽

Keisuke Yamamoto ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Hypertrophic Cardiomyopathy ◽

Left Atrium ◽

Subclavian Vein ◽

Vertical Vein ◽

Left Subclavian Vein

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Extracorporeal Membrane Oxygenation Support in Severe Hypertrophic Obstructive Cardiomyopathy Associated With Persistent Pulmonary Hypertension in an Infant of a Diabetic Mother

Circulation ◽

10.1161/circulationaha.114.010678 ◽

2014 ◽

Vol 130 (21) ◽

pp. 1923-1925 ◽

Cited By ~ 5

Author(s):

Jason F. Goldberg ◽

Carlos M. Mery ◽

Pamela S. Griffiths ◽

Dhaval R. Parekh ◽

Stephen E. Welty ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Extracorporeal Membrane Oxygenation ◽

Hypertrophic Obstructive Cardiomyopathy ◽

Diabetic Mother ◽

Persistent Pulmonary Hypertension ◽

Membrane Oxygenation

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Cor triatriatum sinister with an intact interatrial septum and a decompressing vein in a toddler

Cardiology in the Young ◽

10.1017/s1047951117000130 ◽

2017 ◽

Vol 27 (6) ◽

pp. 1221-1224

Author(s):

Ziyad M. Binsalamah ◽

Luis E. De León ◽

Jeffrey S. Heinle

Keyword(s):

Pulmonary Hypertension ◽

Right Ventricular ◽

Right Ventricular Dysfunction ◽

Right Heart Failure ◽

Interatrial Septum ◽

Cor Triatriatum ◽

Cardiac Anomaly ◽

Severe Tricuspid Regurgitation ◽

Vertical Vein ◽

Cor Triatriatum Sinister

AbstractCor triatriatum sinister is a very rare cardiac anomaly that may lead to pulmonary hypertension, right ventricular dilation, and eventually right heart failure. We report a case of a toddler who presented with respiratory distress and cardiomegaly and was found to have cor triatriatum sinister with a restrictive communication, decompressing vertical vein, pulmonary hypertension, severe tricuspid regurgitation, and severe right ventricular dysfunction. She underwent a successful surgical repair, with normalisation of right ventricular function and pulmonary artery pressure.

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Inhaled nitric oxide therapy for secondary pulmonary hypertension with hypertrophic obstructive cardiomyopathy and severe kyphoscoliosis

International Journal of Cardiology ◽

10.1016/j.ijcard.2011.10.039 ◽

2012 ◽

Vol 158 (1) ◽

pp. e20-e21 ◽

Cited By ~ 2

Author(s):

Yusuke Hosokawa ◽

Takeshi Yamamoto ◽

Yuto Yabuno ◽

Keisuke Hara ◽

Toshiyuki Aokage ◽

...

Keyword(s):

Nitric Oxide ◽

Pulmonary Hypertension ◽

Hypertrophic Obstructive Cardiomyopathy ◽

Inhaled Nitric Oxide ◽

Secondary Pulmonary Hypertension ◽

Nitric Oxide Therapy

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SECTION ON CARDIOLOGY 1996 ANNUAL MEETING PROGRAM

PEDIATRICS ◽

10.1542/peds.98.3.518 ◽

1996 ◽

Vol 98 (3) ◽

pp. 518-536

Keyword(s):

Pulmonary Hypertension ◽

Pulmonary Artery ◽

Cardiac Catheterization ◽

Coil Embolization ◽

Clinical Importance ◽

Left Pulmonary Artery ◽

Meeting Program ◽

Vertical Vein ◽

Subaortic Obstruction ◽

Artery Obstruction

Background: Cardiac catheterization (CC) has been utilized with caution in children on extracorporeal membrane oxygenation (ECMO) due to concerns related to anticoagulation, however there have been no reports of procedure outcome in the literature. This retrospective review was performed to evaluate the indications and outcome of cardiac catheterization (CC) in this population. Methods: We reviewed the catheterization records, hospital charts, and follow up records of all children who have undergone this procedure at our institution from 12/90 to 12/95 (n=14). Records were reviewed to assess indications, results, and complications of CC, as well as clinical outcome. Results: Patients ranged in age from 3 days to 46 months, and diagnoses included single ventricle variants (7), tetralogy of Fallot or variant (4), and others (3). ECMO was utilized preoperatively in 2 pts, and postoperatively in 12 pts; indications for ECMO included low cardiac output or ventricular dysfunction (7), severe hypoxemia (4), and pulmonary hypertension (3). Indications for CC were diagnostic in 12 pts (coronary anatomy, pulmonary artery anatomy, pulmonary vein obstruction, pulmonary hypertension, and/or ventricular function), and interventional in 2 pts (balloon atrial septostomy and aortopulmonary collateral (APC) coil embolization). Two unplanned therapeutic procedures were also performed (coil embolization of APC in 1 pt and of a vertical vein in 1 pt). Adequate evaluation of clinical questions was accomplished in all pts. Unexpected diagnostic information of clinical importance was obtained in 5 pts, including right coronary artery obstruction, significant APC, a vertical vein from a pulmonary venous confluence, left pulmonary artery obstruction, and a restrictive ventricular septal defect causing subaortic obstruction.

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Vein of Galen aneurysm that was diagnosed prenatally and supracardiac obstructed total anomalous pulmonary venous return with pulmonary hypertension: case report

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2011-0004 ◽

2012 ◽

Vol 1 (1-2) ◽

Author(s):

Sema Tanrıverdi ◽

Yeşim Baytur ◽

Nermin Tansuğ ◽

Mecnun Çetin ◽

Şenol Coşkun

Keyword(s):

Pulmonary Hypertension ◽

Venous Return ◽

Heart Diseases ◽

Pulmonary Veins ◽

Vein Of Galen ◽

Vein Of Galen Aneurysm ◽

Vertical Vein ◽

Anomalous Pulmonary Venous Return ◽

The Right ◽

Neonates And Infants

AbstractThe vein of Galen aneurysm is the most common form of symptomatic cerebrovascular malformation in neonates and infants. This anomaly may be diagnosed prenatally by several imaging modalities and causes high cardiac output, which may lead to cardiac failure, in newborns. Total anomalous pulmonary venous return is a rare entity that makes up approximately 0.4%–2% of all congenital heart diseases. The most common type of total anomalous pulmonary venous return is the supracardiac type. The pulmonary veins drain to a confluence posterior to the heart and then to a vertical vein, most commonly on the left, which enters the innominate vein and the drains to the right atrium. Obstructed pulmonary veins with supracardiac-type total anomalous pulmonary venous return can cause severe cardiac and respiratory failure. In this article, a case of a neonate with a vein of Galen aneurysm diagnosed prenatally by magnetic resonance imaging, and a supracardiac obstructed type of total anomalous pulmonary venous return with pulmonary hypertension is presented.

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