Stenting of the obstructed ductus venosus as emergency and bridging strategy in a very low birth weight infant with infradiaphragmatic total anomalous pulmonary venous connection

Burkhardt, Barbara; Stiller, Brigitte; Grohmann, Jochen

doi:10.1002/ccd.25560

Cited by 12 publications

(9 citation statements)

References 12 publications

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“…In fact, although the hepatic sinusoids were the only pathway between the portal vein and the hepatic veins for over 1 month following birth, TAPVC repair had not been required until the exacerbation of pulmonary congestion caused by the in‐stent stenosis. Apparently, we cannot state that the hepatic sinusoids of all infracardiac TAPVC do not contribute to PVO because there have been some reports that stent implantation for DV was effective against pulmonary congestion in neonates …”

Section: Discussionmentioning

confidence: 93%

Fetal case of right atrial isomerism with infracardiac total anomalous pulmonary venous connection and agenesis of the ductus venosus

Kitagawa

Kim

Kawataki

et al. 2019

J of Obstet and Gynaecol

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After birth, the ductus venosus becomes an important route connecting the pulmonary and systemic venous systems for survival in infracardiac total anomalous pulmonary venous connection. We encountered a fetal case of right atrial isomerism with infracardiac total anomalous pulmonary venous connection and agenesis of ductus venosus. Prenatal echocardiography suggested that the fetus had severe pulmonary venous obstruction; however, no obstructive lesions were detected at the level of the vertical vein that drained into the portal veins. Therefore, we concluded that emergency surgical pulmonary venous obstruction release was the only way for the fetus to survive. However, the saturation level was maintained above 70% due to the abundant communications via the hepatic sinusoid over 1 week after birth. In conclusion, hepatic sinusoids can be a sufficient route for pulmonary venous return and may not cause severe pulmonary venous obstruction in infracardiac total anomalous pulmonary venous connection with agenesis of ductus venosus.

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Section: Discussionmentioning

confidence: 93%

Fetal case of right atrial isomerism with infracardiac total anomalous pulmonary venous connection and agenesis of the ductus venosus

Kitagawa

Kim

Kawataki

et al. 2019

J of Obstet and Gynaecol

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“…Low birth weight is an independent risk factor in the operative management of obstructive TAPVC [5,6,9]. Patients who undergo emergent VV stent implantation prior to definitive surgery often present with respiratory distress and cyanosis secondary to pulmonary congestion [4].…”

Section: Discussionmentioning

confidence: 99%

“…It is traditionally considered a surgical emergency. Emergent stenting of the VV is rarely reported but has been performed when a patient is considered a poor candidate for surgical repair [4][5][6]. Pulmonary venous obstruction is associated with poor prognosis and a high risk of operative mortality [7,8].…”

Section: Introductionmentioning

confidence: 99%

Elective Stent Implant in the Obstructed Vertical Vein of Supracardiac Total Anomalous Pulmonary Venous Connection Prior to Operative Repair

Bratincsák¹,

Alstine²,

Koren³

et al. 2017

jshd

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Background: Total anomalous pulmonary venous connection (TAPVC) comprises 2% of congenital heart disease cases. Obstructed TAPVC typically presents with respiratory distress secondary to pulmonary congestion. We report a case of an infant patient who was electively referred to catheterization for stent placement to relieve vertical vein (VV) stenosis. Our objective was to prevent the emergent need for surgical intervention while allowing additional growth before surgery. Case Presentation: A 7-day-old, late pre-term, small for gestational age male infant was transferred from an outside institution. He was initially placed on nasal cannula due to oxygen saturation around 80% but progressed to continuous positive airway pressure and had a chest X-ray suggestive of pulmonary edema. Echocardiography revealed supracardiac TAPVC, a small apical muscular ventricular septal defect, and a moderate secundum atrial septal defect. On admission, the patient was clinically stable with a baseline oxygen saturation of 72% on 40% oxygen. Echocardiography confirmed supracardiac TAPVC and also showed an obstruction with a mean gradient of 22 mmHg in the VV. The desire to optimize the patient's clinical stability led to the decision to undergo cardiac catheterization for stent implantation in the VV. Immediately following the procedure, the patient's hemodynamics improved, with a pressure gradient between the pulmonary venous confluence and the left innominate vein of 4 mmHg. Conclusions: Over the last decade, surgical outcomes IntroductionTotal anomalous pulmonary venous connection (TAPVC) is a rare cardiac defect that comprises 2% of congenital heart disease cases [1]. TAPVC encompasses different anatomic subtypes in which pulmonary veins fail to connect directly to the left atrium and drain to the right atrium via an anomalous venous connection [2,3]. Supracardiac TAPVC is the most common type, comprising about 45% of cases [2]. A left-sided vertical vein (VV) accounts for 70% of the connections between the pulmonary confluence and the right atrium, and stenosis occurs in approximately 40% of cases [3].Obstructed TAPVC typically presents with respiratory distress secondary to pulmonary congestion,

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“…A further two reports have followed . The majority of the literature describes stent implantation for obstructed TAPVC with 19 cases reported to date : 11/19 supracardiac, 6/19 infracardiac, and 2/19 mixed. The preference for stent insertion seems logical given that the obstruction is mostly extrinsic and the relatively disappointing rates of restenosis associated with balloon angioplasty for pulmonary vein stenosis .…”

Section: Discussionmentioning

confidence: 99%

Stent implantation to relieve native obstructed left partial anomalous pulmonary venous connections

McCrossan

O’Callaghan

Walsh

2016

Cathet Cardio Intervent

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Obstructed partial anomalous pulmonary venous connections (APVC) are rare but may be associated with severe pulmonary hypertension (PHTN) and warrant urgent relief. There are a number of case reports of successful catheter intervention for obstructed total APVC. We present the first reported case of catheter intervention to relieve obstructed, left sided PAPVC in a neonate with Turner syndrome. © 2016 Wiley Periodicals, Inc.

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Stenting of the obstructed ductus venosus as emergency and bridging strategy in a very low birth weight infant with infradiaphragmatic total anomalous pulmonary venous connection

Cited by 12 publications

References 12 publications

Fetal case of right atrial isomerism with infracardiac total anomalous pulmonary venous connection and agenesis of the ductus venosus

Fetal case of right atrial isomerism with infracardiac total anomalous pulmonary venous connection and agenesis of the ductus venosus

Elective Stent Implant in the Obstructed Vertical Vein of Supracardiac Total Anomalous Pulmonary Venous Connection Prior to Operative Repair

Stent implantation to relieve native obstructed left partial anomalous pulmonary venous connections

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