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Kim KM, Moon CH, Lee WJ, Kim WJ, Kim M, Jeong J, Lee HB, Jeong SM, Choi HJ, Hwang TS, Lee HC, Yu JH, Nam A, Kim DH. Surgical Correction of a Sinus Venosus Atrial Septal Defect with Partial Anomalous Pulmonary Venous Connections Using Cardiac Computed Tomography Imaging and a 3D-Printed Model. Animals (Basel) 2024; 14:1094. [PMID: 38612332 PMCID: PMC11010815 DOI: 10.3390/ani14071094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/27/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Sinus venosus atrial septal defects (SVASDs), concurrent with partial anomalous pulmonary venous connections (PAPVCs), are a rare congenital heart disease in dogs. Surgical correction is essential when clinical signs or significant hemodynamic changes are present. We aimed to report on the successful surgical correction of an SVASD with PAPVCs, using a computed tomography (CT)-based customized 3D cardiac model. A 10-month-old male poodle was referred for corrective surgery for an ASD. Echocardiography confirmed a hemodynamically significant left-to-right shunting flow through an interatrial septal defect and severe right-sided heart volume overload. For a comprehensive diagnosis, a CT scan was performed, which confirmed an SVASD with PAPVCs. A customized 3D cardiac model was used for preoperative decision-making and surgical rehearsal. The defect was repaired using an autologous pericardial patch under a cardiopulmonary bypass (CPB). Temporary pacing was applied for sinus bradycardia and third-degree atrioventricular block. The patient recovered from the anesthesia without further complications. The pacemaker was removed during hospitalization and the patient was discharged without complications 2 weeks post-surgery. At the three-month follow-up, there was no shunting flow in the interatrial septum and the right-sided volume overload had been resolved. The cardiac medications were discontinued, and there were no complications. This report indicates the validity of surgical correction under CPB for an SVASD with PAPVCs, and the advantages of utilizing a CT-based 3D cardiac model for preoperative planning to increase the surgical success rate.
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Affiliation(s)
- Kyung-Min Kim
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea; (K.-M.K.); (C.-H.M.); (W.-J.L.); (W.-J.K.); (J.J.); (H.-B.L.); (S.-M.J.)
| | - Chang-Hwan Moon
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea; (K.-M.K.); (C.-H.M.); (W.-J.L.); (W.-J.K.); (J.J.); (H.-B.L.); (S.-M.J.)
| | - Won-Jong Lee
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea; (K.-M.K.); (C.-H.M.); (W.-J.L.); (W.-J.K.); (J.J.); (H.-B.L.); (S.-M.J.)
| | - Woo-Jin Kim
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea; (K.-M.K.); (C.-H.M.); (W.-J.L.); (W.-J.K.); (J.J.); (H.-B.L.); (S.-M.J.)
| | - Mihyung Kim
- Chungnam National University Sejong Hospital, 20 Bodeum 7-ro, Sejong-si 30099, Republic of Korea;
| | - Jaemin Jeong
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea; (K.-M.K.); (C.-H.M.); (W.-J.L.); (W.-J.K.); (J.J.); (H.-B.L.); (S.-M.J.)
| | - Hae-Beom Lee
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea; (K.-M.K.); (C.-H.M.); (W.-J.L.); (W.-J.K.); (J.J.); (H.-B.L.); (S.-M.J.)
| | - Seong-Mok Jeong
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea; (K.-M.K.); (C.-H.M.); (W.-J.L.); (W.-J.K.); (J.J.); (H.-B.L.); (S.-M.J.)
| | - Ho-Jung Choi
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea;
| | - Tae Sung Hwang
- Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University, 501 Jinju-daero, Jinju-si 52828, Republic of Korea; (T.S.H.); (H.C.L.)
| | - Hee Chun Lee
- Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University, 501 Jinju-daero, Jinju-si 52828, Republic of Korea; (T.S.H.); (H.C.L.)
| | - Jae Hyeon Yu
- Department of Cardiothoracic Surgery, Chungnam National University Hospital, College of Medicine, Chungnam National University, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Republic of Korea;
| | - Aryung Nam
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea
| | - Dae-Hyun Kim
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea; (K.-M.K.); (C.-H.M.); (W.-J.L.); (W.-J.K.); (J.J.); (H.-B.L.); (S.-M.J.)
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Kazma H, Fakih M, Raad A, Saleh A, Mohammed M. Cor Triatriatum Dexter With a Sinus Venosus Atrial Septal Defect in a 50-Year-Old Woman: A Case Report. Cureus 2024; 16:e53477. [PMID: 38439997 PMCID: PMC10910018 DOI: 10.7759/cureus.53477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2024] [Indexed: 03/06/2024] Open
Abstract
The diagnosis of atrial septal defect (ASD) may be delayed until adulthood or even later in life as it is a well-tolerated congenital heart disease. If patients are not examined and investigated well in childhood, the diagnosis may be delayed until later in adulthood when patients present with palpitations and sometimes dyspnea due to the right chambers dilatation from right ventricular volume overload. In this report, we present a case of a 50-year-old female patient with symptoms of heart failure and atrial fibrillation who was found to have dilated right cardiac chambers, dilated pulmonary artery, severe tricuspid regurgitation, pulmonary hypertension, and a pulmonary-to-systemic flow ratio (Qp/Qs) of more than 1.5 by transthoracic echocardiography and Doppler, indicating left to right shunt at the atrial level. However, transthoracic echocardiography could not visualize the defect, and two-dimensional (2D) transesophageal echocardiography was done in this patient and documented the presence of a sinus venosus ASD with an incomplete cor triatriatum dexter membrane; all four pulmonary veins were identified going to the left atrium. Since the presence of an incomplete cor triatriatum dexter membrane (despite causing no symptoms) makes the percutaneous closure of the sinus venosus ASD and the percutaneous repair of tricuspid regurgitation very difficult, we decided to advise surgical ASD closure and tricuspid valve repair for the patient.
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Affiliation(s)
- Hasan Kazma
- Cardiology, Bahman Hospital, Beirut, LBN
- Medicine, Lebanese University Faculty of Medical Sciences, Beirut, LBN
| | - Malak Fakih
- Cardiology, Bahman Hospital, Beirut, LBN
- Cardiology, Lebanese University Faculty of Medicine, Beirut, LBN
| | - Ali Raad
- Pulmonary and Critical Care, Bahman Hospital, Beirut, LBN
| | - Aalaa Saleh
- General Medicine, Lebanese University Faculty of Medical Sciences, Beirut, LBN
| | - Malek Mohammed
- Invasive Cardiac Laboratory, Bahman Hospital, Beirut, LBN
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Milstein JA, Beer D, Thomson J, Cedars A, Konstantinidis K. Atrial Fibrillation Ablation in a Patient With SV ASD and PAPVR Preceding Transcatheter Septal Closure. JACC Case Rep 2023; 15:101862. [PMID: 37283841 PMCID: PMC10240272 DOI: 10.1016/j.jaccas.2023.101862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 06/08/2023]
Abstract
Atrial fibrillation (AF) is common in adults with unrepaired atrial septal defects (ASDs). Sinus venosus (SV) ASDs associated with partial anomalous pulmonary venous return (PAPVR) are traditionally managed surgically. We report the first AF catheter ablation in a patient with SV ASD and PAPVR preceding transcatheter ASD repair with a covered stent. (Level of Difficulty: Advanced.).
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Affiliation(s)
- Jenna A. Milstein
- Division of Cardiology, Johns Hopkins Medicine, Baltimore, Maryland, USA
| | - Dominik Beer
- Geisinger Heart Institute, Danville, Pennsylvania, USA
| | - John Thomson
- Division of Cardiology, Johns Hopkins Medicine, Baltimore, Maryland, USA
| | - Ari Cedars
- Division of Cardiology, Johns Hopkins Medicine, Baltimore, Maryland, USA
| | - Klitos Konstantinidis
- Division of Cardiology, Johns Hopkins Medicine, Baltimore, Maryland, USA
- Division of Cardiology, University of Utah School of Medicine, Salt Lake City, Utah, USA
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Dang HQ, Le HT, Nguyen HS. Totally Endoscopic Surgery for Repairing Sinus Venosus Atrial Septal Defect Using Double-Patch Technique on Beating Heart. Innovations (Phila) 2023:15569845231173910. [PMID: 37222446 DOI: 10.1177/15569845231173910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE Minimally invasive cardiac surgery has not been widely applied in repairing sinus venosus atrial septal defect (SV-ASD). Most were minithoracotomy using the single-patch technique for patients with anomalous pulmonary veins (APVs) connecting to the superior vena cava-right atrium (SVC-RA) junction. It is unclear whether patients with APVs draining high to the SVC can be repaired safely and effectively through port access. METHODS From May 2019 to October 2022, 11 consecutive SV-ASD patients with APVs connecting high to the SVC were enrolled in this prospective study. One 12 mm port and 2 trocars (5.5 mm and 10 mm) were established. The pleural and pericardial spaces were filled with CO2. The SVC was snared just below the azygos vein. The RA incision was longitudinally extended along the SVC-RA junction to the SVC. The bovine pericardial patches were used to redirect the APV flow to the left atrium through the ASD and to enlarge the SVC and the SVC-RA junction. RESULTS There were no early or late deaths and no reoperations. The concomitant procedures included 5 patients (45.5%) with patent foramen ovale closure, 2 with ASD extension, and 3 with tricuspid valve repair. No endoscopic failure was recorded. The average cardiopulmonary bypass and operative times were 96 (23) min and 190 (30) min, respectively. No cases of venous stenosis or sinus node dysfunction were noted during follow-up of 16.4 ± 12.2 months. CONCLUSIONS SV-ASD with the APVs draining high to the SVC could be repaired safely and effectively through port access with a double-patch technique.
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Affiliation(s)
- Huy Q Dang
- Division of Minimally Invasive Cardiac Surgery, Cardiovascular Center, Hanoi Heart Hospital, Vietnam
| | - Huong T Le
- Institutes of Preventive Medicine and Public Health, Hanoi Medical University (HMU), Vietnam
| | - Hien S Nguyen
- Department of Pediatric Cardiac Surgery, Hanoi Heart Hospital, Vietnam
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Said SM, ElBokl A, Brown NM, Narasimhan S. Descending thoracic aortic homograft for superior vena caval translocation in the Warden procedure: Report of six cases. J Card Surg 2022; 37:4487-4491. [PMID: 36208106 DOI: 10.1111/jocs.17007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Warden procedure has been described for repair of partial anomalous pulmonary venous connections inserted high into the superior vena cava. In the current report, we describe a new modification. METHODS A total of six patients (five females, 83%) with a mean age of 18.8 ± 10.8 years, underwent a modified Warden procedure with a descending thoracic aortic (DTA) homograft connected to the free wall of the right atrium, rather than to the right atrial appendage in the period between June 2021 and July 2022. RESULTS All patients had evidence of enlarged right-sided cardiac chambers. Two patients had intact interatrial septum (33.3%), while three patients had sinus venosus (50%) and one had secundum atrial septal defects (16.7%). The procedure was performed via minimally invasive right thoracotomy in half of the patients. Patients were extubated in the operating room or soon after. No early mortality or reoperation. One patient required concomitant aortic root replacement and one needed repair of anomalous left upper pulmonary vein connection to the left innominate vein. Follow-up was complete in all patients with a mean of 6.2 ± 4.6 months. No late mortality or reoperation. All patients were discharged on antiplatelet therapy. Follow-up imaging studies showed satisfactory repair with widely patent superior vena caval and pulmonary venous pathways. CONCLUSIONS The use of DTA homograft to facilitate superior vena caval translocation in the modified Warden procedure appears to be beneficial as it decreases tension on the anastomosis and avoids the need for anticoagulation.
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Affiliation(s)
- Sameh M Said
- Division of Pediatric Cardiovascular Surgery, Department of Surgery, Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.,Department of Cardiothoracic Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Amr ElBokl
- Division of Pediatric Cardiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Nicholas M Brown
- Division of Pediatric Critical Care, University of Minnesota, Minneapolis, Minnesota, USA
| | - Shanti Narasimhan
- Division of Pediatric Cardiology, University of Minnesota, Minneapolis, Minnesota, USA
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Hejazi Y, Hijazi ZM, Saloos HA, Ibrahim H, Mann GS, Boudjemline Y. Novel technique for transcatheter closure of sinus venosus atrial septal defect: The temporary suture-holding technique. Catheter Cardiovasc Interv 2022; 100:1068-1077. [PMID: 36183408 DOI: 10.1002/ccd.30415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 09/07/2022] [Accepted: 09/11/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Transcatheter repair of sinus venosus atrial septal defect (SVASD) has become an alternative option to surgical repair. There are potential significant complications related to stent stability in the superior vena cava (SVC) and potential migration of the stent that need to be addressed. Therefore, the technique is still evolving. OBJECTIVES To report results of a new modification "the suture technique" that improves safety profile of positioning and securing a covered stent in the SVC. METHODS This is a descriptive, single center, retrospective review of patients who underwent SVASD closure using the suture technique at our institution between 02/2020 and 08/2022. RESULTS Fourteen patients underwent transcatheter repair of SVASD using the suture technique. All procedures were successful. The suture technique allowed precise stent placement in all patients without any migration or complication. Six patients required additional stent placement at the level of the SVC. One patient had an additional covered stent placed to eliminate a tiny residual shunt. Two patients had negligible residual shunts at the time of the procedure. At follow-up, all patients clinically improved and had significant reduction in right heart size on echocardiography and/or magnetic resonance imaging. No arrhythmia was reported in any patient. None required re-intervention after a mean follow-up of 16.5 ± SD 10.5 months. CONCLUSIONS The suture technique appears to be safe modification. Although our study involves small sample size with no comparative group, we believe our technique offers greater control over stent positioning, reducing the risk of stent embolization and residual shunting in transcatheter closure of SVASD.
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Affiliation(s)
| | - Ziyad M Hijazi
- Sidra Heart Center, Sidra Medicine, Doha, Qatar.,Department of Pediatrics, Weill Cornell Medicine, Ar-Rayyan, Qatar
| | - Hesham Al Saloos
- Sidra Heart Center, Sidra Medicine, Doha, Qatar.,Department of Pediatrics, Weill Cornell Medicine, Ar-Rayyan, Qatar
| | - Haytham Ibrahim
- Sidra Heart Center, Sidra Medicine, Doha, Qatar.,Department of Pediatrics, Weill Cornell Medicine, Ar-Rayyan, Qatar
| | - Gurdeep S Mann
- Body Imaging Unit, Division of Cardiac Imaging, Sidra Medicine, Doha, Qatar
| | - Younes Boudjemline
- Sidra Heart Center, Sidra Medicine, Doha, Qatar.,Department of Pediatrics, Weill Cornell Medicine, Ar-Rayyan, Qatar
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Haddad RN, Bonnet D, Gewillig M, Malekzadeh-Milani S. Modified safety techniques for transcatheter repair of superior sinus venosus defects with partial anomalous pulmonary venous drainage using a 100-mm Optimus-CVS® covered XXL stent. Catheter Cardiovasc Interv 2022; 99:1558-1562. [PMID: 35192742 DOI: 10.1002/ccd.30136] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/24/2022] [Accepted: 02/03/2022] [Indexed: 11/07/2022]
Abstract
We report the first use of a single 100-mm long custom-made version of the Optimus-CVS® balloon-expandable PTFE-covered XXL (15-Zig) stent (AndraTec, GmbH) to eliminate sinus venosus defect left-to-right shunt and redirect anomalous right pulmonary veins blood flow through a new walled channel to the left atrium. Anatomical feasibility and strategy decision were guided by ex-vivo procedure simulation on the patient-specific 3D printed heart model and in-vivo balloon interrogation. Modified procedural and implantation techniques are detailed. Immediate and one-month follow-up showed excellent outcomes.
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Affiliation(s)
- Raymond N Haddad
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, Assistance Publique- Hôpitaux de Paris (AP-HP), Paris, France
| | - Damien Bonnet
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, Assistance Publique- Hôpitaux de Paris (AP-HP), Paris, France.,Université de Paris, Paris, France
| | - Marc Gewillig
- Department of Pediatric Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Sophie Malekzadeh-Milani
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, Assistance Publique- Hôpitaux de Paris (AP-HP), Paris, France
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Darbari A, Sharma G, Patil PL, Kumar B, Sharma R. Cardiac Computed Tomography as a Diagnostic Modality for the Assessment of Complex Congenital Heart Disease Management. Cureus 2021; 13:e16838. [PMID: 34513427 PMCID: PMC8410508 DOI: 10.7759/cureus.16838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 12/02/2022] Open
Abstract
Here, we present a case of partial anomalous pulmonary venous return with the superior type of sinus venosus atrial septal defect. This case also had unusually persistent left-sided superior vena cava, which could not be diagnosed well in preoperative transthoracic echocardiography and required contrast-enhanced cardiac computed tomography scanning for proper diagnosing, operative planning, and avoidance of intraoperative problems. Postoperative, cardiac computed tomography scanning was also done to confirm adequate management.
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Affiliation(s)
- Anshuman Darbari
- Department of Cardiothoracic & Vascular Surgery (CTVS), All India Institute of Medical Sciences, Rishikesh, IND
| | - Garima Sharma
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, IND
| | - Prashant L Patil
- Department of Cardiothoracic & Vascular Surgery (CTVS), All India Institute of Medical Sciences, Rishikesh, IND
| | - Barun Kumar
- Department of Cardiology, All India Institute of Medical Sciences, Rishikesh, IND
| | - Rahul Sharma
- Department of Cardiothoracic & Vascular Surgery (CTVS), All India Institute of Medical Sciences, Rishikesh, IND
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Chowdhury UK, Anderson RH, George N, Singh S, Sankhyan LK, Gayatri SB, Malik V, Gharde P, Sengupta S. A Review of the Surgical Management of Anomalous Connection of the Right Superior Caval Vein to the Morphologically Left Atrium and Biatrial Drainage of Right Superior Caval Vein. World J Pediatr Congenit Heart Surg 2020; 11:466-484. [PMID: 32645787 DOI: 10.1177/2150135120912677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present perspective is a synthesis of published investigations in the setting of anomalous connection of the right superior caval vein to the morphologically left atrium or biatrial drainage of the right caval vein. We identified 57 suitable cases from 97 investigations, reviewing the clinical presentation, diagnostic modalities utilized, surgical techniques used, and their outcomes. Clinical presentation, radiographic findings, saline contrast echocardiography, computed tomographic angiocardiography, radionuclide perfusion scan, magnetic resonance imaging, and angiocardiography provided the diagnostic information and were used to define the disease entities before surgery. We have also addressed several issues concerning the influence of the so-called heterotaxy: the establishment of the diagnosis, the variation in clinical presentation, and subsequent management. For the overall group of patients undergoing either surgical intervention or transcatheter treatment with an Amplatzer vascular plug, the operative mortality remains high at 9.5%. We submit that an increased appreciation of these disease entities will contribute to improved future surgical management.
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Affiliation(s)
- Ujjwal Kumar Chowdhury
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Robert H Anderson
- Biosciences Institute, Newcastle University. Newcastle upon Tyne, United Kingdom
| | - Niwin George
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Sukhjeet Singh
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Lakshmi Kumari Sankhyan
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Sushama B Gayatri
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Vishwas Malik
- Department of Cardiac Anaesthesia, All India Institute of Medical Sciences, New Delhi, India
| | - Parag Gharde
- Department of Cardiac Anaesthesia, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjoy Sengupta
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
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Abstract
Partial anomalous pulmonary venous drainage (PAPVD) is a rare congenital cardiac defect and is associated with sinus venosus atrial septal defect. While most cases are asymptomatic, a patient can present with pulmonary hypertension (PHTN) and it can be difficult to diagnose. Here, we discuss the case of a young female with PHTN who was found to have two right-sided PAPVD. Through this case, authors try to emphasize the importance of meticulous and thorough investigation when evaluating PHTN, which allows for correct diagnosis and a timely intervention before PHTN becomes irreversible.
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Affiliation(s)
- Hiten R Patel
- Department of Cardiology, Saint Joseph's Regional Medical Center, New York Medical College, New Jersey, USA
| | - Suchit Bhutani
- Department of Internal Medicine, Abington Hospital-Jefferson Health, Philadelphia, USA
| | - Fayez Shamoon
- Department of Cardiology, Saint Joseph's Regional Medical Center, New York Medical College, New Jersey, USA
| | - Hartaj Virk
- Department of Cardiology, Saint Joseph's Regional Medical Center, New York Medical College, New Jersey, USA
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Bodian M, Aw F, Bamba MN, Kane A, Jobe M, Tabane A, Mbaye A, Sarr SA, Diao M, Sarr M, Bâ SA. Sinus venosus atrial septal defect: a rare cause of misplacement of pacemaker leads. Int Med Case Rep J 2013; 6:29-32. [PMID: 23847433 PMCID: PMC3707482 DOI: 10.2147/imcrj.s45784] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Routine implantation of pacemakers and implantable cardioverter defibrillators is not commonly associated with complications. However, in some cases we see misplacement of pacemaker leads which is most often related to the presence of underlying cardiac anomalies. We report the case of misplacement of a pacemaker lead into the left ventricle of a 56-year-old patient paced in VVI/R mode and with a tined type pacemaker lead because of a symptomatic complete atrioventricular block. Electrocardiogram showed a pacemaker-generated rhythm with a right bundle branch block pattern. Chest X-ray showed the pacemaker lead located relatively high in relation to the diaphragm. Echocardiography visualized the pacemaker lead in the left heart chambers (atrium and ventricle), hence confirming its aberrant course. Further, the defect causing its passage to the left heart chambers was a sinus venosus atrial septal defect. The patient reported no complication related to the misplacement of the lead. After a brief period of oral anticoagulation, the lead was inserted into the right ventricle by percutaneous technique.
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Affiliation(s)
- Malick Bodian
- Department of Cardiology, Aristide Le Dantec Teaching Hospital
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12
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Uppu SC, Chandrasekaran S, Mallula KK. Constrictive pericarditis in a patient with sinus venosus atrial septal defect and anomalous right upper pulmonary venous return. Ann Pediatr Cardiol 2011; 2:87-8. [PMID: 20300278 PMCID: PMC2840771 DOI: 10.4103/0974-2069.52820] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This is a report of a 49-year-old male, who presented with typical signs and symptoms of constrictive pericarditis. He was diagnosed with sinus venosus atrial septal defect (ASD) and anomalous right upper pulmonary venous return during his adolescence, which was elected not to be repaired. During the attempted repair of the ASD it was noted there was a thick fibrous material covering the heart, which had progressed over time leading to frank constrictive pericarditis. His ASD spontaneously closed over time. There have been less than 10 cases reported with constrictive pericarditis of nonsurgical etiology in a patient with ASD, and none with sinus venosus ASD.
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Affiliation(s)
- Santosh C Uppu
- Departments of Internal Medicine and Pediatrics, Albert Einstein Medical Center, Philadelphia, PA, USA
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