Modified In Situ Pericardial Rerouting Technique for Scimitar Syndrome Repair

Lugones, Ignacio; Biancolini, María Fernanda; Pacheco, Victoria Eugenia Zerpa; Martínez, Inés Ana; Barbosa, Jesús María Maximiliano Damsky; Dios, Ana M S de

doi:10.1177/2150135117732540

Cited by 10 publications

(36 citation statements)

References 3 publications

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“…90 Repair when the pulmonary veins are distant from the left atrium is challenging, and may eventuate in a higher prevalence of pulmonary or inferior caval venous stenosis, or intracardiac baffle obstruction. [3][4][5]13,58,61,64,89,90 A myriad of surgical techniques has been described for managing distant anomalous pulmonary veins, including mobilization and direct CHOWDHURY ET AL.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, direct implantation is more reasonable for horizontal scimitar veins. 61 Opinion is divided regarding the approach to aortopulmonary collateral arteries. 24,76 While some have demonstrated the beneficial effects of coil embolization on reduction of pulmonary hypertension and congestive heart failure, others have an inconsistent experience.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5]24,64,92 The risk of postoperative obstruction increases with circular direct anastomoses, acute angulation of veins, the requirement for increased mobilization, and handling or clamping at the time of surgery. [3][4][5]13,58,61,64,89,90 Although the pericardial tunnel, or "sutureless," technique as described by Sun et al 63 addresses several drawbacks that increased risk of pulmonary venous obstruction of other techniques, it is difficult to apply in cases of marked right-sided positioning of the heart, and hypoplasia of the right lung. Lugones et al 61,71 described a modification of their original rerouting technique using the sutureless concept, along with repositioning of the atrial septum.…”

Section: Discussionmentioning

confidence: 99%

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Surgical management of the scimitar syndrome

Chowdhury

Anderson

Sankhyan

et al. 2021

Journal of Cardiac Surgery

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Background and Aim: We sought to address the varied anatomical details, the diagnostic challenges, associated cardiopulmonary anomalies, the techniques, and outcomes of management, including re-interventions of scimitar syndrome.Methods: A total of 92 published investigations of scimitar syndrome were reviewed. Diagnostic information was provided by clinical presentations, radiographic findings, transthoracic and transesophageal echocardiography, computedtomographic angiography, magnetic resonance imaging, angiocardiography, and ventilation/perfusion scans. These investigations served to elucidate the origin, course, and termination of the scimitar vein, the intracardiac anatomy, the presence of associated defects, and the patterns of any accompanying pulmonary lesions prior to surgical intervention.Results: Of the patients described, up to four-fifths presented during infancy, with cardiac failure, increased pulmonary flow, and pulmonary hypertension. Associated cardiac and extracardiac defects, particularly hypoplasia of the right lung, are present in up to three-quarters of cases. Overall operative mortality has been cited between 4.8% and 5.9%. Mortality was highest in patients with preoperative pulmonary hypertension, and those undergoing surgery in infancy. Despite timely surgical intervention, post-repair obstruction of the scimitar vein, intra-atrial baffle obstruction, or stenosis of the inferior caval vein were reported in up to two-thirds of cases. The venous obstruction could not be related to any particular surgical technique. On long term follow-up, one sixth of patients reported persistent dyspnoea and recurrent respiratory infections.Conclusions: Any infants presenting with heart failure, right-sided heart, and hypoplastic right lung should be evaluated to exclude the syndrome. An increased appreciation of variables will contribute to improved surgical management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Surgical management of the scimitar syndrome

Chowdhury

Anderson

Sankhyan

et al. 2021

Journal of Cardiac Surgery

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“…No patients in the series developed diaphragm paralysis or phrenic nerve palsy. Outcomes after other methods for APV drainage distant from the left atrium are infrequently reported 3,4,[8][9][10][11][12] and variable. Possible surgical techniques employed for managing distant anomalous pulmonary veins include mobilization and direct reimplantation into left atrial wall, use of interposition grafts, and creation of an intra-atrial baffle from the orifice of the anomalous veins to the left atrium through a preexisting or constructed atrial septal defect.…”

Section: Commentmentioning

confidence: 99%

Early Outcomes for In Situ Pericardial Roll Repair for Distant Anomalous Pulmonary Venous Return

Najm

Ahmad

Salam

et al. 2021

The Annals of Thoracic Surgery

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“…Scimitar syndrome is a congenital heart disease involving the pulmonary venous connection to the right heart in association with pulmonary abnormalities. Symptoms include hypoplasia of the right lung and pulmonary branch along with the sequestration of the right lower lobe as well as the large aortic collaterals (4,5). The infantile form usually requires surgical intervention; however, the adult form is usually asymptomatic and surgical repair is dependent on the severity of the left-right shunt (4,6,7).…”

Section: Introductionmentioning

confidence: 99%

Two Cases of Scimitar Syndrome: An Adolescent and an Older Adult with Late Diagnosis

Omrani

Dehaki

Abbaszadeh

et al. 2019

Multidiscip Cardio Annal

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Introduction: Scimitar syndrome, a rare form of congenital heart disease (CHD), is characterized by anomalous pulmonary venous return into the inferior vena cava, hypoplasia of the right lung, and dextroposition of heart. The most common form of the syndrome known as infantile form, is diagnosed in infancy and is surgically corrected. Asymptomatic cases are occasionally diagnosed in adolescence. However, there are rare cases which remain undiagnosed until older ages despite some manifestations of the disease. This is in part due to the nonspecific nature of this manifestations which necessitates a specific workup for the diagnosis and treatment. Case Presentation: We report two cases of scimitar syndrome in female patients, one 17 years old and another 48 years old. Here we described the symptoms, diagnosis and clinical course of these patients and reviewed the literature on Scimitar syndrome particularly in adolescents and adults. Conclusions: Although Scimitar syndrome has early manifestations in most of the patients, its late diagnosis is sometimes seen in adolescents and adults due to misdiagnosis. Surgical repair can correct the blood flow route and improve the outcomes.

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Modified In Situ Pericardial Rerouting Technique for Scimitar Syndrome Repair

Cited by 10 publications

References 3 publications

Surgical management of the scimitar syndrome

Surgical management of the scimitar syndrome

Early Outcomes for In Situ Pericardial Roll Repair for Distant Anomalous Pulmonary Venous Return

Two Cases of Scimitar Syndrome: An Adolescent and an Older Adult with Late Diagnosis

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