Iatrogenic diversion of the inferior vena cava into the left atrium diagnosed 43 years after surgical atrial septal defect closure

Abstract

The diversion of the inferior vena cava into the left atrium after surgical atrial septal defect closure is a fatal complication. Cases of atrial septal defect with no inferior rim should be treated with this complication in mind.

Usefulness of Transesophageal Echocardiography in Diagnosing the Cause of Circulatory Collapse During Reoperation for an Inferior Vena Cava-Left Atrium Shunt After Atrial Septal Defect Closure: A Case Report

“…5,9 Iatrogenic diversion of the IVC to the LA after ASD repair is an uncommon complication, described in several case reports. 4–7,9…”

“…5,9 Iatrogenic diversion of the IVC to the LA after ASD repair is an uncommon complication, described in several case reports. [4][5][6][7]9 The Eustachian valve is a remnant of an embryonic structure, the sinus venosus valve, located near the IVC orifice. 10 In an inferior sinus venosus ASD or inferiorly positioned secundum ASD, the Eustachian valve can be misidentified as the lower margin of the atrial septum and included in the suture line, resulting in an iatrogenic IVC-LA shunt.…”

“…2,3 Notably, the Eustachian valve can be misidentified as the lower margin of the ASD and become included in the suture line, resulting in an iatrogenic inferior vena cava (IVC)-left atrium (LA) shunt. 4–7…”

“…2,3 Notably, the Eustachian valve can be misidentified as the lower margin of the ASD and become included in the suture line, resulting in an iatrogenic inferior vena cava (IVC)-left atrium (LA) shunt. [4][5][6][7] Here, we report a case of circulatory collapse due to stenosis between the IVC and right atrium (RA) caused by a residual incorrectly placed patch that became apparent after closure of a true ASD.…”