Surgical Approach to Left Ventricular Inflow Obstruction Due to Dilated Coronary Sinus

Vargas, Florentino J.; Rozenbaum, J; López, Rosa; Granja, Miguel; Dios, Ana De; Zarlenga, Beatriz; Flores, Enrique; Fischman, Enrique; Kreutzer, Eduardo A.

doi:10.1016/j.athoracsur.2006.02.062

Cited by 13 publications

(5 citation statements)

References 11 publications

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“…[ 6 ] Left ventricular inflow obstruction has also been reported due to left SVC with dilated CS and may even mimic features of cor triatriatum sinister. [ 7 ]…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of absent right superior vena cava with intraoperative transesophageal echocardiography in a child with Holt-Oram syndrome

Misra

Mohanty

Sathia

et al. 2021

Annals of Cardiac Anaesthesia

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Holt-Oram syndrome is a rare autosomal disorder with cardiac, vascular, and upper limb anomalies. Previous reports have described anesthetic and perioperative challenges including difficulty in arterial and venous cannulations, airway management and rhythm, and temperature abnormalities. There are no previous reports of absent right superior vena cava (SVC) in children with Holt-Oram syndrome. We present images of a case where the diagnosis of absent right SVC with persistent left SVC was made with intraoperative transesophageal echocardiography and discuss the anesthetic and perfusion implications of such findings.

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“…[ 6 ] Left ventricular inflow obstruction has also been reported due to left SVC with dilated CS and may even mimic features of cor triatriatum sinister. [ 7 ]…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of absent right superior vena cava with intraoperative transesophageal echocardiography in a child with Holt-Oram syndrome

Misra

Mohanty

Sathia

et al. 2021

Annals of Cardiac Anaesthesia

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“…This was not done in the case reported on in this issue of the Journal by Gowda and colleagues. 5 And although the outcome was good in the case of Vargas and associates, 4 there was a residual mean gradient of 4 mm Hg across the mitral valve. The central message from the Vargas experience was that in the absence of a right superior vena cava and bridging innominate vein, there is a need for a more extensive coronary sinus reduction angioplasty to obtain effective complete relief of the left ventricular inflow obstruction.…”

Section: Roosevelt Bryant III Mdmentioning

confidence: 95%

“…In some cases, the LSVC can simply be ligated in patients with a bridging innominate vein to a right superior vena cava; however, patients with a persistent LSVC and a dilated coronary sinus often do not have a bridging innominate vein. In the absence of a bridging innominate vein, Vargas and associates 4 proposed a modification of the coronary sinus reduction. They proposed a more extensive reduction coronary sinus angioplasty along its entire length in the left atrium, with reimplantation of the LSVC into the right atrial appendage.…”

Section: Roosevelt Bryant III Mdmentioning

confidence: 99%

No longer novel: The association of a dilated coronary sinus with left ventricular inflow obstruction

Bryant

2017

The Journal of Thoracic and Cardiovascular Surgery

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“…We chose to do this study in a postmortem series, allowing for precise delineation of malformations, rather than relying solely on imaging studies, as has been done in some other series [3,6,[19][20][21]. Imaging studies have generally concentrated on specific cardiac findings, and most have not included extracardiac malformations.…”

Section: Introductionmentioning

confidence: 98%

“…The purpose of our study was to determine what cardiac (as well as noncardiac) malformations were seen in association with PLSVC, how many were cases of HLHS, and whether any of these lacked anatomic causes for this, a finding that might lend support to the idea that PLSVC can sometimes significantly impede ventricular inflow. We chose to do this study in a postmortem series, allowing for precise delineation of malformations, rather than relying solely on imaging studies, as has been done in some other series [3,6,[19][20][21]. Imaging studies have generally concentrated on specific cardiac findings, and most have not included extracardiac malformations.…”

Section: Introductionmentioning

confidence: 99%

Persistent Left Superior Vena Cava: Does it Have a Role in the Pathogenesis of Hypoplastic Left Heart Syndrome?

Taweevisit

Thorner

2011

Pediatr Dev Pathol

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The coexistence of a persistent left superior vena cava (PLSVC) and congenital anomalies, both cardiac and noncardiac, is well documented, but whether PLSVC contributes to the development of cardiac malformations is controversial. We conducted a retrospective review of perinatal and pediatric autopsies to determine the association between PLSVC and other congenital anomalies. Of 362 patients, 91 (25%) had congenital heart disease and 19 (5.2%) had PLSVC. Eight cases (47%) were associated with specific syndromes, including heterotaxy syndrome, trisomy 18, trisomy 13, and Jacobsen syndrome. Seventeen cases of PLSVC (89%) were associated with congenital heart disease, most of which were complex. Isolated PLSVC was found in 2 cases (11%). Eight of the 19 PLSVC cases (47%) were associated with hypoplastic left heart syndrome (HLHS), a result that was statistically significant (P = 0.041). Left ventricle inflow/outflow obstruction is believed to be a critical pathogenic factor in the development of HLHS. Whereas 5 of 8 cases of HLHS had additional obstructive cardiac outflow tract lesions, 3 of 8 cases did not. PLSVC is known to be able to compromise left ventricle inflow via a dilated coronary sinus, and we speculate that PLSVC may have played a contributing role in the pathogenesis of HLHS in these three cases. As an isolated lesion, PLSVC would not be sufficient to cause HLHS, but it might contribute in combination with other obstructive lesions, or in the setting of other genetic and/or environmental factors still to be defined for HLHS. A larger series will be needed to confirm this hypothesis.

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Surgical Approach to Left Ventricular Inflow Obstruction Due to Dilated Coronary Sinus

Cited by 13 publications

References 11 publications

Diagnosis of absent right superior vena cava with intraoperative transesophageal echocardiography in a child with Holt-Oram syndrome

Diagnosis of absent right superior vena cava with intraoperative transesophageal echocardiography in a child with Holt-Oram syndrome

No longer novel: The association of a dilated coronary sinus with left ventricular inflow obstruction

Persistent Left Superior Vena Cava: Does it Have a Role in the Pathogenesis of Hypoplastic Left Heart Syndrome?

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