Iatrogenic cyanosis and clubbing: 25 years of chronic hypoxia after the repair of an atrial septal defect

Diversion of the Inferior Vena Cava Into the Left Atrium After Surgical Repair of Atrial Septal Defect

“…This is an unusual case discovered 9 years after the first operation. The symptoms of this complication generally appear soon after surgery when the patient becomes cyanotic and hypoxic; however, some factors such as the relief of pulmonary venous congestion and right ventricular strain by the correction of the left-to-right shunt, the occurrence of only partial diversion of the IVC flow to the LA, and the occurrence of stenosis of the IVC, with collaterals draining to the SVC through an azygos vein may contribute to the appearance of the symptoms of this complication later in life (3) . Reported factors associated with this complication include a large secundum defect or sinus venosus defect, and anomalous pulmonary return into the RA (4) .…”

“…Awareness of this complication is very important since such patients may be misdiagnosed with Eisenmenger's syndrome (3) .…”

Surgical repair of diversion of inferior vena cava into the left atrium nine years after surgical repair of atrial septal defect

“…Usually the symptoms of this complication appear soon after surgery when the patient becomes cyanotic and hypoxic however some factors such as the relief of pulmonary venous congestion and right ventricular strain by the correction of the left-to-right shunt, the occurrence of only partial diversion of the IVC flow to the LA, and the occurrence of stenosis of the IVC, with collaterals draining to the superior vena cava through an azygos vein may contribute to the appearance of the symptoms of this complication later in life. (3) Reported factors associated with this complication include a large secundum defect or sinus venosus defect, and anomalous pulmonary return into the RA. (4) In our case we observed that the inferior rim of the defect was not included in the first surgical closure.…”

Iatrogenic diversion of IVC to left atrium after surgical closure of ASD

“…[8] But with the advances in cardiac imaging and more awareness of this complication, these lesions can be discovered earlier. Traditionally, contrast echocardiogram with venous access in the lower limb and cardiac catheterization with IVC angiogram have been used to diagnose this complication.…”