Echocardiographic-Guided Placement of Venous Cannula Due to Inferior Vena Cava Obstruction Through a Large Eustachian Valve

Supranational (international) guidelines for management of the heart structural anomalies

“…Персистирующий ЕК больших размеров может вызывать обструкцию нижней полой вены [154,155] или перенаправлять кровь из нижней полой вены в ЛП через дефект МПП, вызывая появление цианоза [156,157].…”

Transesophageal echocardiography for diagnosis of inadvertant closure of Inferior Vena Cava opening during minimally invasive atrial septal defect closure

“…There are reports of using TEE for placement of cannulas for cardiopulmonary bypass (CPB) [1][2][3] as well as for diagnosing problems like poor venous return during CPB. [4] We present a case in which intraoperative TEE assisted in the diagnosis of inadvertant surgical obstruction of inferior vena cava (IVC) during minimally invasive atrial septal defect (ASD) closure.…”

Inadequate venous drainage-transesophageal echocardiography as rescue

“…Inadequate venous return to the cardiopulmonary bypass circuit may be caused by air in the venous return line, low blood volume, obstruction of the cannula, or inappropriate cannula placement. [ 1 ] The right hepatic vein, middle hepatic vein, and left hepatic veins drains into IVC shortly before it enters the right atrium. The right hepatic vein is large vein which enters the IVC at an obtuse angle.…”

“…[ 2 ] The Large eustachian valve can also obstruct venous cannula inflow intermittently during direct insertion through a median sternotomy or during femoral cannulation. [ 1 ] IVC with right hepatic vein is best visualized with transgastric echocardiographic view with probe turned to right side and angle of about 60°. Turning the probe to counterclockwise from above position with an angle of 50°–90° can show middle hepatic vein.…”