Correction of Anomalous Systemic Venous Drainage: Transposition of Left SVC to Left PA

Takach, Thomas J.; Cortelli, Michael; Lonquist, James L.; Cooley, Denton A.

doi:10.1016/s0003-4975(96)00901-0

Cited by 19 publications

(13 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…When needed, surgical connection is possible with either intra-or extra-cardiac procedures [1][2][3][4][5][6]. The few cases reported in literature have been treated with: a) division and re-implantation of the LSVC to right atrium [1,4]; b) an intra-atrial baffle or graft to divert flow from the LSVC to the right atrium and to close the ASD [1,2,4,7]; c) anastomosis of the LSVC to the left pulmonary artery [6,8,9] Our patient presented with a combination of persistent LSVC draining into the LA, a large ostium secundum ASD, coronary veins draining into the LA and pulmonary hypertension responding to pulmonary vasodilators. The multiple anomalous connections between the systemic and pulmonary circulation did not translate into a particularly high Qp/Qs, likely due to concomitant presence of left-to-right and right-to-left shunts.…”

Section: Discussionmentioning

confidence: 99%

Extra-anatomic correction of persistent left superior vena cava draining into the left atrium associated with atrial septal defect.

Grandinetti

Molfetta

Farina

et al. 2020

Preprint

View full text Add to dashboard Cite

Persistent left superior vena cava draining into the left atrium is a rare condition. We herein report the case of a 34-year-old male admitted at our institution for paroxysmal atrial fibrillation. Investigations revealed a large ostium secundum atrial septal defect, with a persistent left superior vena cava draining into the left atrium, while the coronary veins drained separately into the left atrium. Surgical correction was performed, closing the defect with a patch and connecting the left superior vena cava to the right atrial appendage with an extra-cardiac conduit. History of presentation A 34-year-old male was admitted to our hospital following the sudden onset of palpitation and shortness of breath. His past medical history, otherwise unremarkable, included hypertension and overweight (BMI 28.2 Kg/m 2). Physical examination revealed clubbing and low SpO 2 (90%). Investigations Electrocardiogram revealed atrial fibrillation, which reverted spontaneously to sinus rhythm. Transthoracic echocardiogram revealed a large ostium secundum atrial septal defect (ASD), 41x42mm in size, with left-toright shunt, pulmonary hypertension (60mmHg) and dilatation of the right ventricle. Computed tomography (CT) scan showed: (1) a persistent left superior vena cava (LSVC) draining into the left atrium (LA) in close proximity to the left atrial appendage, (2) the absence of a left brachiocephalic vein, (3) the abnormal independent drainage of the coronary veins in the LA. The great cardiac vein drained into the postero-lateral wall, the marginal vein into the lower wall and two middle cardiac veins into the medial-lower wall of the LA (Fig. 1; Fig 2). Cardiac catheterisation confirmed pulmonary hypertension (pulmonary arterial pressure 70/44mmHg; mean 45mmHg, wedge pressure 14mmHg), arterial SpO2 91%, systemic venous saturation 70% and pulmonary artery saturation 90%, Qp/Qs 2.8. Nitric oxide caused a significant reduction of pulmonary artery and wedge pressures, with an increment of the Qp/Qs to 11.5. The patient was referred and accepted for elective surgery. Management Surgery was performed through full median sternotomy. The absence of the left brachiocefalic vein was confirmed. The LSVC entered the LA cephalad and medial to the left superior pulmonary vein (Fig 3 and

show abstract

Section: Discussionmentioning

confidence: 99%

Extra-anatomic correction of persistent left superior vena cava draining into the left atrium associated with atrial septal defect.

Grandinetti

Molfetta

Farina

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…En la reintervención no se consideró la corrección intraauricular 11 por 2 razones: una aurícula izquierda pequeña en un lactante con DCSAV desequilibrado y para eludir la circulación extracorpórea. Tampoco era viable la reconexión directa de la VCSI con la orejuela derecha 12 por la lejanía entre ambas estructuras y la interposición aórtica, y se rechazó el Glenn bidireccional 13 dada la presión pulmonar en un DCSAV. El implante de un conducto de Gore-Tex entre la vena innominada y la aurícula derecha ha sido descrito en un niño mayor 14 .…”

Section: Discussionunclassified

Ausencia de vena cava superior derecha y vena cava superior izquierda con drenaje en el seno coronario sin techo

Ramos

Fernández-Pineda

Tamariz-Martel

et al. 2005

Revista Española de Cardiología

View full text Add to dashboard Cite

“…6 These have included simple ligation of the LSVC, 1 -3 division and reimplantation of the LSVC to RA, 7,8 an intra-atrial baffle to divert flow from the LSVC to the RA and closure of the ASD, 6,9 graft interposition to the RA, 1 –3,10 and anastomosis of the LSVC to LPA. 8,11,12…”

Section: Commentmentioning

confidence: 99%

“…12 Nineteen years later, Takach and associates reported a repair of obstructive intra-atrial baffle using this technique. 11 In order to avoid the above-mentioned short- and long-term complications, we decided to transect the LSVC-LA junction and transpose the LSVC to the LPA. The driving forces behind our decision were the desire to (1) utilize an extracardiac approach, which is less invasive than an intracardiac repair, (2) reduce myocardial ischemic time, (3) have growth potential of the systemic venous pathway, (4) avoid obstruction of the left atrial outlet, (5) maintain an embryological step of left-to-right collateral communication in the venous system in a less aggressive manner than an acute ligation, and (6) apply the surgical principle for all cases of persistent LSVC with normal pulmonary artery pressure and pulmonary vascular resistance.…”

Section: Commentmentioning

confidence: 99%

Left Bidirectional Cavopulmonary Connection in Raghib’s Defect: Report of 5 Cases and Review of Literature

Sankhyan

Chowdhury

Diplomate

et al. 2019

World J Pediatr Congenit Heart Surg

View full text Add to dashboard Cite

We report five male patients aged 3, 6, 8, 10, and 15 years, respectively, undergoing left bidirectional cavopulmonary connection and concomitant Dacron patch closure of the atrial septal defect for Raghib’s defect with persistent left superior vena cava. The circulation was successfully corrected. This extracardiac procedure uses only autogenous tissues having growth potential, reduces myocardial ischemia, and avoids later baffle deterioration with pulmonary venous obstruction associated with intra-atrial baffling procedures. A wider appreciation and application of this management modality is warranted.

show abstract

Correction of Anomalous Systemic Venous Drainage: Transposition of Left SVC to Left PA

Cited by 19 publications

References 7 publications

Extra-anatomic correction of persistent left superior vena cava draining into the left atrium associated with atrial septal defect.

Extra-anatomic correction of persistent left superior vena cava draining into the left atrium associated with atrial septal defect.

Ausencia de vena cava superior derecha y vena cava superior izquierda con drenaje en el seno coronario sin techo

Left Bidirectional Cavopulmonary Connection in Raghib’s Defect: Report of 5 Cases and Review of Literature

Contact Info

Product

Resources

About