Transjugular closure of a two-hole atrial septal defect in a child with iliac vein thrombosis

Başpınar, Osman; Al-Hadidy, Khaleel Ibrahim; Kervancıoğlu, Mehmet

doi:10.4103/0974-2069.115280

Cited by 7 publications

(10 citation statements)

References 5 publications

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“…The right internal jugular vein has also been occasionally used as an alternative venous access site, with good results reported in literature. 3,[6][7][8][9][10] In our patient, in whom the superior caval vein (SCV) was on the left side due to the situs inversus and, in the absence of the inferior caval vein, the manipulation of the devices necessary to implant the prosthesis from the azygos vein or from the right internal jugular through the innominate vein down to the left-sided SVC and the right atrium would be considerably difficult, with great possibility of failure. For this reason, the left internal jugular vein was chosen.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous closure of ostium secundum atrial septal defect using left internal jugular vein access in a child with situs inversus and absence of inferior caval vein

et al. 2019

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Femoral vein access is the first choice for percutaneous atrial septal defect closure, and when it cannot be used due to anatomic reasons, the alternative sites should be considered, frequently increasing the complexity of the procedure. Here we report the case of a 3-year-old boy, with situs inversus and dextrocardia, electively referred for percutaneous closure of an ostium secundum atrial septal defect. During the procedure, agenesis of the infra-hepatic segment of the inferior caval vein was diagnosed, and no double inferior caval vein or right superior caval vein were identified by ultrasound or angiography. Therefore, we opted to perform the procedure through the left internal jugular vein, with fluoroscopy and transesophageal echocardiographic guidance. Catheters were navigated through a hydrophilic guidewire, and a Stiff guidewire was positioned in the left ventricle for better support. An Amplatzer septa occluder 19 was successfully deployed without major difficulties and the patient was discharged after 24 hours in good clinical condition. Percutaneous atrial septal defect closure through alternative access sites, especially in the presence of situs inversus, may pose significant challenges to the interventional team. In this case, the left internal jugular vein has shown to be a feasible option, allowing the navigation and manipulation of devices without complications. Provided the expertise of the interventional team, and awareness of the risks involved, alternative access sites can be successfully used for paediatric structural interventions.

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Section: Discussionmentioning

confidence: 99%

Percutaneous closure of ostium secundum atrial septal defect using left internal jugular vein access in a child with situs inversus and absence of inferior caval vein

et al. 2019

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“…Congenital abnormalities of the IVC that have been reported in some patients undergoing transcatheter secundum ASD repair are IVC absence and interruption with azygous continuation. 1,5,6,9 However, to the best of our knowledge, a similar case of transcatheter secundum ASD closure in a patient with situs ambiguus and a left-sided IVC has rarely been reported in the literature.…”

Section: Discussionmentioning

confidence: 97%

“…2 Transcatheter closure mostly via the transfemoral approach is considered the treatment of choice for secundum ASD. [3][4][5][6] Situs ambiguus (also known as heterotaxia) refers to an abnormal distribution of the thoracic and/or abdominal viscera organs in a manner that does not totally conform with situs inversus. 7 It has an incidence of 1:10 000 births and it is associated with congenital heart defects (CHD) with a coincidence as high as 100%.…”

Section: Introductionmentioning

confidence: 99%

Secundum Atrial Septal Defect Closure via the Transhepatic Approach in a Patient With Situs Ambiguus and a Left-Sided Inferior Vena Cava

Olagunju

Mihyawi

Moazez

et al. 2021

Journal of Investigative Medicine High Impact Case Reports

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Secundum atrial septal defect (ASD) is the most common type of ASD. Symptoms including dyspnea on exertion usually manifest in the third and fourth decade of life. The transcatheter closure is the treatment of choice for secundum ASD. The transfemoral venous approach has been the mainstay. However, this approach can be challenging or impossible in patients with congenital absence or interruption of the inferior vena cava (IVC). The latter has been reported in patients with situs ambiguus and inversus. In this patient population, other forms of venous access such as the transjugular or transhepatic approach are used. We present a unique case of symptomatic secundum ASD in a patient who was incidentally found to have situs ambiguus with a left-sided intact IVC. An initial attempt at the ASD closure via the transfemoral approach was unsuccessful due to acute angulation. A repeat attempt was successful via the transhepatic approach with the guidance of real-time ultrasound, transesophageal echocardiogram, and the involvement of an interventional radiologist. The procedure was well tolerated without any complications. Repeat transthoracic echocardiogram with agitated saline the day after the procedure was negative for interatrial shunting.

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“…This was a complication most likely due to previous femoral venous access during prolonged ICU stay in neonatal period On reviewing the literature, we could find only few case reports, mainly in adults, of transjugular approach for percutaneous closure of ASD (4,5,6,7,8). In pediatric age group we could find only two case reports (9,10) The difficulties associated with the transjugular approach include placing a large sheath in the jugular vein, manipulating the wire and catheter past the defect, and stabilizing the catheter or guidewire prior to deployment of device. Also there is a significant risk of air embolism during the procedure.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Closure of ASD in a Child with Bilateral Femoral Vein Obstruction: An Unconventional Route

2017

ARC Journal of Clinical Case Reports

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Transjugular closure of a two-hole atrial septal defect in a child with iliac vein thrombosis

Cited by 7 publications

References 5 publications

Percutaneous closure of ostium secundum atrial septal defect using left internal jugular vein access in a child with situs inversus and absence of inferior caval vein

Percutaneous closure of ostium secundum atrial septal defect using left internal jugular vein access in a child with situs inversus and absence of inferior caval vein

Secundum Atrial Septal Defect Closure via the Transhepatic Approach in a Patient With Situs Ambiguus and a Left-Sided Inferior Vena Cava

Percutaneous Closure of ASD in a Child with Bilateral Femoral Vein Obstruction: An Unconventional Route

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