We describe a 13-month-old patient with tetralogy of Fallot, left pulmonary artery discontinuity, and supracardiac totally anomalous pulmonary venous drainage to the azygos vein. The diagnosis and the management of this rare association are briefly discussed.
Prolonged cardiorespiratory support can be achieved with ECMO that may provide time for myocardial recovery, prevent multiorgan dysfunction and reduce mortality. Left ventricle (LV) distension can worsen already distended and hypocontractile heart. Early recognition and aggressive management of LV distension are essential for the treatment of patients with low cardiac output. The case report presented intends to show advantages of left ventricular venting on ECMO after post-cardiotomy shock. With direct flow measurements on bypass-grafts before and after the vent implantation, it was possible to clearly demonstrate the importance of venting for myocardial perfusion.
The congenital stenosis of the inferior vena cava (IVC) is a rare anomaly causing
numerous clinical manifestations, depending on the variant of drainage patterns
or collaterals. This case presents a ϐive-year-old Azerbaijani male, who suffered
with massive ascites and a leg edema for three months. IVC stenosis was
detected on echocardiography, due to a high velocity ϐlow and visualisation of
a focal narrowing between the IVC oriϐice and the proximal end of the hepatic
vein entry. The IVC stenosis was conϐirmed by computed tomography. Surgical
dilatation of the IVC using xeno-pericardial patchplasty was performed under
the cardiopulmonary bypass. This successful surgical correction of IVC stenosis
is the only case ever reported in Azerbaijan.
Key words: surgical repair, congenital stenosis, inferior vena cava, computed
tomography , IVC stenosis
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