Drainage of the Inferior Vena Cava to the Left Atrium

Burri, Haran; Vuille, Cédric; Sierra, Jorge; Didier, Dominique; Lerch, René; Kalangos, Afksendyios

doi:10.1046/j.1540-8175.2003.03009.x

Cited by 22 publications

(17 citation statements)

References 13 publications

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“…However, these congenital findings have been reported in asymptomatic patients referred for evaluation of incidentally noted hypoxemia or cyanosis. 3 Most patients with vena caval drainage to the LA diagnosed either congenitally or after incorrect ASD repair undergo surgery to correct hypoxemia or to reduce the theoretical risk of future arterial embolization. Although a previous diagnostic evaluation including bone marrow biopsy was unable to diagnose the cause of polycythemia, we believe that the second patient developed secondary polycythemia as a result of right-to-left shunt as a complication of the ASD repair in 1964.…”

Section: Discussionmentioning

confidence: 99%

“…1 Much rarer, an anomalous right SVC connects to the LA. 2 Similarly rare is inferior vena caval (IVC) return to the LA, which has been reported as a congenital anomaly often occurring with atrial septal defect (ASD), 3 as well as a postcardiac surgical complication, typically caused by incorrect closure of the IVC after repair of an inferiorly located ASD. 4 We present multimodality imaging of a case of a right SVC connecting to the LA and a case of an IVC connecting to the LA.…”

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confidence: 99%

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Anomalous Vena Caval Return to the Left Atrium

et al. 2012

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A nomalous vena caval return to the left atrium (LA) is a rare congenital anomaly. The most common variant is a persistent left superior vena cava (SVC), estimated to occur among 2.1% to 4.3% of hearts with congenital defects. 1 Much rarer, an anomalous right SVC connects to the LA. 2 Similarly rare is inferior vena caval (IVC) return to the LA, which has been reported as a congenital anomaly often occurring with atrial septal defect (ASD), 3 as well as a postcardiac surgical complication, typically caused by incorrect closure of the IVC after repair of an inferiorly located ASD. 4 We present multimodality imaging of a case of a right SVC connecting to the LA and a case of an IVC connecting to the LA. Case PresentationThe first patient is a 45-year-old woman who was referred for evaluation of her increasing shortness of breath and nearly syncopal episodes over a 1-year period. Physical examination revealed a resting hypoxia of 90% on room air and a systolic murmur. Her ECG and chest x-ray were normal (Figures I and II in the online-only Data Supplement). A transesophageal echocardiogram (Figure 1 and Movies I and II in the online-only Data Supplement) revealed a sinus venosus ASD and anomalous right superior pulmonary venous return. Cardiac magnetic resonance imaging demonstrated a right SVC draining the majority of its contents to the LA, an anomalous right upper pulmonary vein draining into the SVC, and an atypical sinus venosus defect (Figures 2 and 3 and Movies III and IV in the online-only Data Supplement). Phase-contrast magnetic resonance imaging of the pulmonary arterial and aortic flow found the shunt ratio (Qp/Qs) to be 0.81 (Figure 4). The patient underwent a Warden procedure that involved transection of the SVC above the highest pulmonary vein, closure of the cardiac end, closure of the ASD, and anastomosis of the free end of the SVC to the right atrial appendage (Figure 1 and Movie II in the online-only Data Supplement). She tolerated the procedure well and was discharged to rehabilitation a few days later, asymptomatic and with normalized oxygen saturation.The second patient is a 62-year-old man transferred to our hospital for open surgical ASD repair. He had a reported history of exertional dyspnea in childhood leading to an open ASD repair in 1964 at 16 years of age at an outside hospital with no records available. Three years after ASD repair, he was diagnosed with polycythemia. An extensive evaluation that included a bone marrow biopsy did not identify a cause. He has been undergoing phlebotomy on a weekly basis for 43 years. His examination revealed oxygen saturation of 89% on room air; scleral, lip, and digital cyanosis without clubbing; and a pansystolic murmur. ECG and chest x-ray were normal (Figures III and IV in the online-only Data Supplement). More recently, he had developed symptomatic paroxysmal atrial fibrillation and underwent an attempted ablation, which

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confidence: 99%

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confidence: 99%

Anomalous Vena Caval Return to the Left Atrium

et al. 2012

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“…At 4 months of life, both the septum primum and septum secundum exist as separate membranes with free atrial communication via the ostium primum and ostium secundum. The sinus venosus communicates with the left and right atria through a left and right valve respectively; later, it migrates to the right, with the left valve disappearing (4). The right valve then atrophies, leaving only the Eustachian valve of the IVC and the Thebesian valve of the coronary sinus as remnants.…”

Section: Ivc Drainage Into Left Atriummentioning

confidence: 99%

Congenital anomalies of the IVC—embryological perspective and clinical relevance

Ghandour¹,

Partovi²,

Karuppasamy³

et al. 2016

Cardiovasc. Diagn. Ther.

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With the increased use of cross-sectional imaging, systemic venous anomalies are more frequently being recognized in asymptomatic patients. Accurate characterization of systemic venous anomalies plays a major role in the appropriate selection of a surgical approach or interventional procedure.In this article, we review common and uncommon inferior vena cava (IVC) anomalies. We describe the embryological basis and clinical implications of these anomalies, particularly from an interventional radiology perspective. We also discuss the complications and treatments of these anomalies.

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“…The IVC drainage into the LA is a rare congenital anomaly, and is less commonly associated with an ASD. Most of the published articles are individual case reports [1][2][3][4][5][6]. It may occur in conjunction with other anomalies, such as anomalous pulmonary venous drainage and pulmonary arteriovenous fistulae.…”

Section: Discussionmentioning

confidence: 99%

“…Only few cases have been reported in the literature [1][2][3][4][5][6]. Because of this, the natural course, clinical manifestations and diagnosis are not well established.…”

Section: Introductionmentioning

confidence: 99%

Atrial septal defect with drainage of the inferior vena cava into the left atrium

Aliter

Elhaddad

Gallo

et al. 2011

European Journal of Cardio-Thoracic Surgery

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Atrial septal defect (ASD) with drainage of the inferior vena cava (IVC) into the left atrium (LA) is a rare congenital anomaly. Few cases have been reported in the literature. We present a 17-year-old female with an ASD and an anomalous drainage of the IVC into the LA leading to cyanosis since early childhood. Diagnosis was documented by computed tomography (CT) angiography and confirmed intra-operatively. The patient underwent successful surgical correction with an uneventful postoperative course.

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Drainage of the Inferior Vena Cava to the Left Atrium

Cited by 22 publications

References 13 publications

Anomalous Vena Caval Return to the Left Atrium

Anomalous Vena Caval Return to the Left Atrium

Congenital anomalies of the IVC—embryological perspective and clinical relevance

Atrial septal defect with drainage of the inferior vena cava into the left atrium

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