Novel use of a retroaortic innominate vein in cavopulmonary anastomosis

Agarwal, Rajesh; Ganapathy, Krishnan; Kulkarni, Snehal; Bhatt, Kinnari; Cherian, Kotturathu Mammen

doi:10.1016/j.jtcvs.2006.02.045

Cited by 9 publications

(11 citation statements)

References 5 publications

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“…The ASLBVs were mostly kept unchanged during the cardiac operation in the previously reported cases. In a case with tricuspid atresia and hypoplastic pulmonary artery, this vein was used as an augmentation material of the central pulmonary artery during cavopulmonary anastomosis (Agarwal et al, 2006). During the cardiac operation, great caution is required in the cases with ASLBV during dissection or manipulation of the central pulmonary artery or cross-clamping of the ascending aorta, especially during operations performed within a small surgical field.…”

Section: Discussionmentioning

confidence: 99%

Anomalous subaortic left brachiocephalic vein in surgical cases and literature review

et al. 2010

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Anomalous subaortic left brachiocephalic vein (ASLBV) is a rare systemic venous anomaly. We review our experience with patients associated with ASLBV who underwent cardiac surgery at three institutions. From 1989 to 2009, the medical records of surgically treated patients with ASLBV were analyzed; the incidence of ASLBV, clinical characteristics, and associated anatomical findings were assessed. Fifteen patients had ASLBV. All ASLBVs coursed left lateral to the aortic arch, passed under the ascending aorta anterior to the central pulmonary artery, and joined the right brachiocephalic vein. Fourteen patients had congenital heart disease (CHD), and the remaining patient did not have cardiac anomalies. Its incidence was 0.57% (14 of 2,449) in patients with CHD and only 0.02% (1 of 4,805) in patients without CHD. In patients with CHD, 73.3% (11 of 15) of the patients had conotruncal cardiac anomalies such as tetralogy of Fallot, ventricular septal defect with pulmonary atresia, truncus arteriosus, and interruption of the aortic arch. Eight patients had aortic arch anomalies, including right aortic arch and cervical aortic arch. The deletion of chromosomal 22q11.2 was confirmed in two patients, and one patient was diagnosed with DiGeorge syndrome. ASLBV was clinically silent even without any surgical intervention. ASLBV is a very rare anomaly and is highly associated with conotruncal cardiac anomalies and aortic arch anomalies, including right aortic arch and cervical aortic arch. Preoperative diagnosis is important when any surgical interventions are intended, especially, in patients with conotruncal cardiac anomalies.

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Section: Discussionmentioning

confidence: 99%

Anomalous subaortic left brachiocephalic vein in surgical cases and literature review

et al. 2010

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“…Agarwal et al , reported a case of tricuspid atresia and pulmonary atresia with bifurcation stenosis of confluent pulmonary arteries where the retroaortic vein was used for pulmonary artery reconstruction while performing a cavopulmonary anastomosis. [12] Baba et al , reported another case with superoinferior ventricles with retroaortic innominate vein where it was used for a right atrial pulmonary anastomosis. [13]…”

Section: Discussionmentioning

confidence: 99%

Retroaortic left innominate vein - Incidence, association with congenital heart defects, embryology, and clinical significance

et al. 2008

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“…11 There have been reports in literature where subaortic brachiocephalic vein has been used for performing cavo-pulmonary and right atrial-pulmonary anastomosis. 17…”

Section: Discussionmentioning

confidence: 99%

Anomalous subaortic course of brachiocephalic vein: Evaluation on multidetector computed tomography angiography

Verma

Pandey

Ramakrishnan

et al. 2021

Journal of Cardiac Surgery

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Aim: To evaluate the morphology and associated cardiovascular abnormalities in patients with an anomalous subaortic course of brachiocephalic vein on multidetector computed tomography (CT) angiography.Material and Methods: A retrospective study was performed at a tertiary referral institute to identify patients with subaortic brachiocephalic vein on multidetector CT (MDCT) angiography using dual source CT scanner between January 2014 and July 2021. The morphology of the subaortic brachiocephalic vein along with the cardiovascular anatomy and associated anomalies were evaluated.Results: Out of 4349 patients who had undergone MDCT angiography for evaluation of congenital heart diseases, we identified 126 (2.9%) patients with subaortic brachiocephalic vein. The subaortic brachiocephalic vein was left-sided in 125 patients while a right-sided subaortic brachiocephalic vein was identified in a patient with left isomerism. Common cardiovascular associations included tetralogy of Fallot (109/126; 88.1%), double outlet right ventricle (8/126; 6.3%) and common arterial trunk (5/126; 3.9%). The presence of a right aortic arch was seen in 78/126 (62%) patients. Some degree of right ventricular outflow obstruction was present in 119/ 126 (94.4%) patients; pulmonary stenosis was seen in 78 (62%) patients while pulmonary atresia was seen in 41 (32.5%) patients. Conclusion:A subaortic brachiocephalic vein can coexist with various complex congenital heart diseases, most commonly tetralogy of Fallot and commonly associated with right aortic arch and pulmonary stenosis/atresia. It is important to identify this anomalous course of brachiocephalic vein before performing surgical procedures or venous catheterization to avoid potential complications.

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Novel use of a retroaortic innominate vein in cavopulmonary anastomosis

Cited by 9 publications

References 5 publications

Anomalous subaortic left brachiocephalic vein in surgical cases and literature review

Anomalous subaortic left brachiocephalic vein in surgical cases and literature review

Retroaortic left innominate vein - Incidence, association with congenital heart defects, embryology, and clinical significance

Anomalous subaortic course of brachiocephalic vein: Evaluation on multidetector computed tomography angiography

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