Visualization of Sinus Venosus-type Atrial Septal Defect by Biplane Transesophageal Echocardiography

Watanabe, Fumiyoshi; Takenaka, Katsu; Suzuki, Jun–ichi; Amano, Wataru; Shiota, Takahiro; Igarashi, Tsutomu; Aoki, Toshiro; Sonoda, Makoto; Wang, Yuepeng; Sakamoto, Tsuguya; Sugimoto, Tsuneaki

doi:10.1016/s0894-7317(14)80125-9

“…Previously reported transoesophageal echocardiographic (TOE) findings of SVD have failed to recognise the pathognomonic morphological features of SVD. 11 As the detection of SVD by the transthoracic echocardiographic approach in adults has several limitations 12 (the posterior location of the defect makes it difficult to identify from precordial examination), there is no doubt that TOE should be the procedure of choice for the diagnosis of SVD [13][14][15][16] and the associated congenital anomalies. 17 Therefore, the aim of this report is to discuss the anatomical features of SVD on the basis of preoperative TOE examination and its relation to surgical assessment.…”

mentioning

confidence: 99%

Sinus venosus syndrome: atrial septal defect or anomalous venous connection? A multiplane transoesophageal approach

Oliver

¹

,

Gallego

²

,

González

³

et al. 2002

Heart

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Objective: To discuss the anatomical features of sinus venosus atrial defect on the basis of a comprehensive transoesophageal echocardiography (TOE) examination and its relation to surgical data. Methods: 24 patients (13 men, 11 women, mean (SD) age 37 (17) years, range 17-73 years) with a posterior interatrial communication closely related to the entrance of the superior (SVC) or inferior vena cava (IVC) who underwent TOE before surgical repair. Records of these patients were retrospectively reviewed and compared with surgical assessments. Results: In 13 patients, TOE showed a deficiency in the extraseptal wall that normally separates the left atrium and right upper pulmonary vein from the SVC and right atrium. This deficiency unroofed the right upper pulmonary vein, compelling it to drain into the SVC, which overrode the intact atrial septum. In three patients, TOE examination showed a defect in the wall of the IVC, which continued directly into the posterior border of the left atrium. Thus, the intact muscular border of the atrial septum was overridden by the mouth of the IVC, which presented a biatrial connection. In the remaining eight patients, the defect was located in the muscular posterior border of the fossa ovalis. A residuum of atrial septum was visualised in the superior margin of the defect. Neither caval vein overriding nor anomalous pulmonary vein drainage was present.Conclusions: Sinus venosus syndrome should be regarded as an anomalous venous connection with an interatrial communication outside the confines of the atrial septum, in the unfolding wall that normally separates the left atrium from either caval vein. It results in overriding of the caval veins across the intact atrial septum and partial pulmonary vein anomalous drainage. It should be differentiated from posterior atrial septal defect without overriding or anomalous venous connections.

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“…Previously reported transoesophageal echocardiographic (TOE) findings of SVD have failed to recognise the pathognomonic morphological features of SVD. 11 As the detection of SVD by the transthoracic echocardiographic approach in adults has several limitations 12 (the posterior location of the defect makes it difficult to identify from precordial examination), there is no doubt that TOE should be the procedure of choice for the diagnosis of SVD [13][14][15][16] and the associated congenital anomalies. 17 Therefore, the aim of this report is to discuss the anatomical features of SVD on the basis of preoperative TOE examination and its relation to surgical assessment.…”

mentioning

confidence: 99%

Pronounced PR depression

Lee¹

2002

Heart

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Objective: To discuss the anatomical features of sinus venosus atrial defect on the basis of a comprehensive transoesophageal echocardiography (TOE) examination and its relation to surgical data. Methods: 24 patients (13 men, 11 women, mean (SD) age 37 (17) years, range 17-73 years) with a posterior interatrial communication closely related to the entrance of the superior (SVC) or inferior vena cava (IVC) who underwent TOE before surgical repair. Records of these patients were retrospectively reviewed and compared with surgical assessments. Results: In 13 patients, TOE showed a deficiency in the extraseptal wall that normally separates the left atrium and right upper pulmonary vein from the SVC and right atrium. This deficiency unroofed the right upper pulmonary vein, compelling it to drain into the SVC, which overrode the intact atrial septum. In three patients, TOE examination showed a defect in the wall of the IVC, which continued directly into the posterior border of the left atrium. Thus, the intact muscular border of the atrial septum was overridden by the mouth of the IVC, which presented a biatrial connection. In the remaining eight patients, the defect was located in the muscular posterior border of the fossa ovalis. A residuum of atrial septum was visualised in the superior margin of the defect. Neither caval vein overriding nor anomalous pulmonary vein drainage was present.Conclusions: Sinus venosus syndrome should be regarded as an anomalous venous connection with an interatrial communication outside the confines of the atrial septum, in the unfolding wall that normally separates the left atrium from either caval vein. It results in overriding of the caval veins across the intact atrial septum and partial pulmonary vein anomalous drainage. It should be differentiated from posterior atrial septal defect without overriding or anomalous venous connections.

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