Role of intraoperative echocardiography in surgical correction of the superior sinus venosus atrial septal defect

Abstract

Superior type of sinus venosus atrial septal defect (SVASD) is invariably associated with the unroofing of right upper pulmonary vein (RUPV). Warden procedure and pericardial patch repair with rerouting of the RUPV are commonly performed operations for the superior SVASD. Both operations involve the risk of obstruction to the flow of superior vena cava or rerouted pulmonary vein in the postoperative period. The sinus venosus defects are well visualized on the transesophageal echocardiography (TEE) because of the proximity of the TEE probe to these structures. We are reporting two cases operated for the superior SVASD with unroofed RUPV, highlighting the intraoperative echocardiographic features before and after the surgery.

Anomalous Connection of Superior Vena Cava to Left Atrium—A Rare Congenital Cardiac Anomaly and Its Implications

“…11 We describe various anomalous right-to-left systemic connections, their intraoperative TEE features, and clinical implications for the better understanding of these anomalies (Table). 4,10–13…”

“…11 We describe various anomalous right-to-left systemic connections, their intraoperative TEE features, and clinical implications for the better understanding of these anomalies (Table ). 4,[10][11][12][13] Routinely, intravenous lines are placed on the upper extremities before induction of anesthesia, as it is technically easy and avoids dislodgement. It also provides better comfort to the patient, aids in early ambulation, and lowers the incidence of thrombosis after surgery.…”

Role of Perioperative Echocardiographic in Surgical Correction of the Pulmonary Venous Anomalies

“…The view of RIPV is obtained by rotating the probe clockwise from the view of RUPV at either the modified bicaval view or at the 30 to 40° sector angle from the ME four-chamber view and then rotating the probe slightly clockwise, which was obtained in our patient. 11 Persistent left SVC is the most common congenital thoracic venous anomaly with a prevalence of 0.3 to 0.5% in general population. The most common subtype of PLSVC results in the presence of both left and right SVCs.…”

Sinus venosus atrial septal defect and partial anomalous pulmonary venous connection in a patient with dextrocardia

“…However, diagnosis of SVASD on TTE may sometimes be difficult because the atrial septum appears intact in most view. 4 On the other hand, the validity of TEE in the diagnosis of SVASD and PAPVC has been reported. 5 6 In our case, due to the unusual situation of dextrocardia with situs inversus, TEE was performed by an experienced operator; however, congenital anomalies could still not be detected.…”

“…Echocardiography is typically used to diagnose ASD. However, diagnosis of SVASD on TTE may sometimes be difficult because the atrial septum appears intact in most view 4. On the other hand, the validity of TEE in the diagnosis of SVASD and PAPVC has been reported 5 6.…”