Tetralogy of Fallot With Right Aortic Arch and Retro-Aortic Innominate Vein

Lim, Zhia; Chew, Bryan; Yong, Sanfui; Corno, Antonio F.

doi:10.3389/fped.2018.00331

Cited by 5 publications

(9 citation statements)

References 8 publications

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“…Deep hypothermic circulatory arrest has been employed for separate cannulation of the caval veins, or exposure of the aortic arch or pulmonary arteries. This technique has also been suggested to be impractical because of the short superior caval vein, and the small operating field 5,56,75 . The principles of surgery are dictated by the concomitant cardiac anomalies.…”

Section: Resultsmentioning

confidence: 99%

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Surgical management of lesions encountered in the setting of the retroaortic left brachiocephalic vein

Chowdhury

Anderson

Sankhyan

et al. 2021

Journal of Cardiac Surgery

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Background and Aim Although the retroaortic left brachiocephalic vein in isolation is of no clinical importance, its recognition in the setting of associated lesions is important. We sought to address issues concerning the influence of isomerism, the establishment of diagnosis, and its importance in various surgical and interventional procedures. Methods A total of 80 published clinical and necropsy studies in the setting of a retroaortic left brachiocephalic vein described 250 patients. Clinical presentation, radiographic, ultrasonographic findings, contrast echocardiography, computed‐tomographic angiocardiography, magnetic resonance imaging, and angiocardiography provided the diagnostic information prior to considering the surgical approach to the associated cardiac anomalies. Results Among 250 reported cases, three‐quarters had associated congenitally malformed hearts. Of these 189 patients, all but seven had usual atrial arrangement. Right isomerism was reported in five patients and two patients having left isomerism. Almost two‐thirds had tetralogy of Fallot or its variants, over four‐fifths had malformations involving the outflow tract, two‐thirds had a right aortic arch with two patients having a cervical aortic arch, and onepatient had double aortic arch. Various innovative individualized surgical procedures were employed with an overall perioperative mortality of 3.4%. Conclusions Although the retroaortic left brachiocephalic vein is asymptomatic, its recognition during clinical investigation should raise the possibility of an association with other malformations, especially right aortic arch, ventricular septal defect, and anomalies of the outflow tracts. We submit that an increased appreciation of this venous anomaly may facilitate surgical planning, endovascular procedures, placement of central venous lines, and transvenous pacemakers.

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Section: Resultsmentioning

confidence: 99%

“…As far as we are aware, around 250 cases have now been reported since 1980 1–80 . When found in isolation, the anomalous course is of no clinical importance.…”

Section: Introductionmentioning

confidence: 97%

Surgical management of lesions encountered in the setting of the retroaortic left brachiocephalic vein

Chowdhury

Anderson

Sankhyan

et al. 2021

Journal of Cardiac Surgery

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“…Although retroaortic brachiocephalic vein was described as a very rare anatomical variant in the general population (2/100000) and (5/1000) in CHD by Corno et al [37], we have found 3 TOF patients (3.8%) with retroaortic brachicephalic vein that also having rightsided AA. Lim et al [38] published it as a case report in 3-month girl TOF patient using echocardiography. This may be attributed that it is easier to sequentially delineate this venous variant by MDCT than that by echocardiography.…”

Section: Role Of Mdct In Assessment Of Associated Anomaliesmentioning

confidence: 99%

“…This may be attributed that it is easier to sequentially delineate this venous variant by MDCT than that by echocardiography. Awareness of this venous anomaly is beneficial to avoid transvenous pacemaker or central venous catheter placement from left-arm approach and to minimize perioperative risks [38].…”

Section: Role Of Mdct In Assessment Of Associated Anomaliesmentioning

confidence: 99%

Three steps approach for preoperative evaluation of tetralogy of Fallot patients: role of 128 MDCT

Moustafa

Hussein

Sultan

et al. 2021

Egypt J Radiol Nucl Med

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Background Tetralogy of Fallot is the most common congenital cyanotic heart disease. Advances in surgical repair recently facilitate survival of the affected patients into adulthood with good quality of life. Despite imaging plays crucial role in diagnosis of TOF patients, no single diagnostic modality suffices for complete evaluation of TOF. Thus, different diagnostic tools should be used alone or in combination according to patient’s clinical question. This study aims to find out the agreement between the echocardiography and MDCT in evaluation of TOF patients prior to surgical repair. Results Three-step approach used in scanning TOF patients. Firstly, classic TOF findings, MDCT was comparable to echocardiography in overriding aorta (k = 0.6), VSD (k = 0.8), RVH (k = 0.4), and sub valvular pulmonary stenosis (k = 0.6). Echocardiography is superior to MDCT in evaluation of valvular stenosis (k = 0.4). MDCT was superior to echocardiography in supravalvular pulmonary stenosis. Secondary, surgical relevant findings, McGoon ratio calculated in 94.2%, small and major APCs in 45.5% and 28.5% respectively, PDA in 35% and anomalous coronary artery in 5.1%. Thirdly, other TOF-associated anomalies, common: ASD (34.3%) and RAA (28.3%), and persistent LSVC (10.3%). Uncommon: situs ambiguous (2.5 %), PAPVR (1.2%), and IVC anomalies (3.8%). MDCT was superior to echocardiography in surgical relevant findings and other TOF-associated anomalies. Conclusion MDCT is a crucial imaging tool for extra cardiac evaluation of TOF patients prior to surgical repair.

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“…Retroaortic innominate vein (RAIV) is a rare anomaly that passes posterior to the ascending aorta to join the superior vena cava (SVC) (1)(2)(3). RAIV occurrence is known to be associated with congenital heart disease (CHD) and, very rarely, with a normal heart structure (4,5). The RAIV itself is asymptomatic and does not require treatment, but if its presence is not confirmed, problems may arise when invasive tests and treatments are performed.…”

Section: Introductionmentioning

confidence: 99%

Case Report: Retroaortic Innominate Vein With Supracardiac Total Anomalous Pulmonary Venous Connection

et al. 2021

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A retroaortic innominate vein (RAIV) is a rare anomaly that passes posterior to the ascending aorta to join the superior vena cava and is associated with congenital heart disease (CHD). The RAIV and normal left innominate vein (LIV) rarely duplicate. The etiology of the RAIV and its relationship with CHD remains unknown. We report a case involving a 1-month-old baby girl with RAIV and supracardiac total anomalous pulmonary venous connection (TAPVC). Transthoracic echocardiogram demonstrated a pulmonary venous confluence (CPV) posterior to the left atrium, an abnormal vertical vein (VV) that originated from the CPV, and a normally positioned LIV. Three-dimensional cardiac computed tomography revealed the VV and RAIV to which it merged. This is the first reported case of a combination of RAIV and isolated TAPVC. We speculate that the VV is connected to the CPV during fetal life, thus leaving the RAIV behind. The RAIV may be detected in various forms with the development of new diagnostic imaging methods. Although a RAIV itself does not require treatment, establishing a correct diagnosis before invasive tests and procedures are performed can help prevent unexpected complications.

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Tetralogy of Fallot With Right Aortic Arch and Retro-Aortic Innominate Vein

Cited by 5 publications

References 8 publications

Surgical management of lesions encountered in the setting of the retroaortic left brachiocephalic vein

Surgical management of lesions encountered in the setting of the retroaortic left brachiocephalic vein

Three steps approach for preoperative evaluation of tetralogy of Fallot patients: role of 128 MDCT

Case Report: Retroaortic Innominate Vein With Supracardiac Total Anomalous Pulmonary Venous Connection

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