Abnorme Einm�ndung von Lungenvenen in die Vena cava cranialis

A Review of the Surgical Management of Anomalous Connection of the Right Superior Caval Vein to the Morphologically Left Atrium and Biatrial Drainage of Right Superior Caval Vein

“…In most cases in which the right SVC drains exclusively to the LA or else exhibits biatrial drainage, saline contrast echocardiography alone gives a clue to the diagnosis. 15,16,20,21,[25][26][27][28][29][30][33][34][35][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57]67,92 In cases where difficulty remains in establishing the diagnosis, cardiac catheterization and angiography are recommended to delineate the anatomic details, including the presence of associated major congenital cardiac lesions, if any. 8,9,14,15,22,25,26,31,48 Magnetic resonance imaging, radionuclide angiography, and computed tomographic angiography are other imaging modalities that may provide an accurate description of the underlying anatomy.…”

“…This was because of lack of symptoms other than mild cyanosis, refusal to undergo surgical intervention, or because of associated major noncardiac congenital malformations. 8,11,[14][15][16][17][26][27][28]41,44,45,49,[51][52][53]56 As described, we found nine different techniques for rechanneling the right SVC. The procedures involve different intracardiac and extracardiac approaches, most recently including percutaneous placement of Amplatzer occluder devices.…”

“…6 -59 It is seen concomitantly with intracardiac anomalies such as atrial or ventricular septal defects, single atrium, tetralogy of Fallot, transposition of the great arteries, functionally univentricular heart, and Eisenmenger complex. 6 …”

“…Moderate left ventricular enlargement and left ventricular hypertrophy have been noted in some patients. 13,14 ,16,50 ,60 The differential diagnoses of a patient with central cyanosis, in the absence of clinically detectable abnormalities of the cardiovascular system, indicate congenital pulmonary arteriovenous malformation, pulmonary artery to LA communication, partially or totally anomalous systemic venous connection to LA, methemoglobinemia, hemoglobinopathies, pulmonary vascular obstructive disease, and Eisenmenger syndrome. 40,61 -63…”

“…Diagnosis is usually made by saline contrast echocardiography, radionuclide angiography, magnetic resonance imaging, computed tomographic angiography, conventional angiocardiography, or during placement of central venous catheter. 45 ,64,65 Saline contrast echocardiography is very useful in the differential diagnosis. Contrast visualization of the LA, left ventricle, and aorta without opacification of the right ventricle with injections into veins of both hands suggests either drainage of the right SVC to the LA or persistence of the left SVC with unroofing of the coronary sinus.…”