Anomalous left hepatic vein to coronary sinus in a patient with atrial septal defect: Minimally invasive approach; technical challenges

Abstract

Left hepatic vein draining into coronary sinus is a rare systemic vascular anomaly. Its presence is significant when it is associated with other cardiac lesions requiring surgery. We report technical challenges in a case of persistent left superior vena cava and left hepatic vein draining into coronary sinus in an adult with ostium secundum atrial septal defect, which was repaired through minimally invasive approach. The main technical challenge in this case was to achieve adequate venous drainage, which was achieved by vacuum assistance and by manipulating the position of femoral venous cannula. We approached through a right anterolateral thoracotomy and adequate venous drainage was achieved without cannulating left hepatic vein or left superior vena cava.

Minimal-Access Atrial Septal Defect (ASD) Closure

“…Most common are the connection of the right pulmonary vein(s) to the IVC ("scimitar vein", which might be associated with sequestration of the right lower lobe), the left upper pulmonary vein(s) to the left innominate vein, and the right upper pulmonary vein(s) connecting high on the SVC. A case report of an anomalous left hepatic vein to coronary sinus in a patient with ASD is also reported [57]. Here, the anomalous connection was repaired using a minimally invasive approach.…”

Inferior sinus venosus defect and anomalous hepatic venous return to the coronary sinus leading to an Eisenmenger syndrome

“…4 In this case, its recognition was important to plan the heartlung transplantation. 5,6 Pulmonary arterial hypertension was likely to be related to the sinus venosus defect and the right ventricle volume overload. Genetic study did not identify atrisk anomaly to date.…”