Cor triatriatum sinister with left anomalous pulmonary venous drainage to innominate vein: what to do with the vertical
- PDF / 1,241,139 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 54 Downloads / 188 Views
CASE REPORT
Cor triatriatum sinister with left anomalous pulmonary venous drainage to innominate vein: what to do with the vertical vein? Keiichi Ishiwari1 · Koji Nomura1 · Yoshihiro Ko1 · Izumi Hamaya1 · Kodai Momoki2 · Tomomitsu Takagi1 Received: 12 February 2020 / Accepted: 12 October 2020 © The Author(s) 2020
Abstract We treated a surgical case of a 47-day-old male infant diagnosed with an unusual type of cor triatriatum sinister (CTS) with left anomalous pulmonary venous drainage to the innominate vein via a vertical vein. After preoperative hemodynamic assessment of pulmonary venous (PV) return, this patient underwent a resection of the fibromuscular membrane between the accessory and the true left atrial chambers, concomitant with vertical vein banding to facilitate a left PV return through a common pulmonary venous collector (CPVC). Catheterization three months after this surgery revealed no obstruction of the PV return to the mitral orifice as well as good growth of the CPVC as a left PV return pathway. The patient has been doing well on aspirin. Keywords Congenital heart disease · Cor triatriatum · Left anomalous pulmonary venous return · Vertical vein · Banding
Introduction Cor triatriatum sinister (CTS) represents only 0.1% of all cardiac malformations [1]. Partial or total anomalous pulmonary venous return (PAPVR/TAPVR) is reported as a coexisting disease in 10–33% of patients with CTS [2], but left anomalous pulmonary venous drainage coexisting with CTS is less frequently described [3–7]. CTS with left anomalous pulmonary venous drainage may be hemodynamically similar to obstructive TAPVR when a common pulmonary venous collector (CPVC) is present, and surgical intervention may be urgently needed [3]. Here, we report a rare urgent surgical case of CTS associated with left anomalous pulmonary venous drainage.
Case A 47-day-old male infant was transferred to our center for evaluation of body weight loss. * Keiichi Ishiwari [email protected] 1
Department of Cardiovascular Surgery, Saitama Children’s Medical Center, Saitama, Japan
Department of Cardiology, Saitama Children’s Medical Center, Saitama, Japan
2
After admission, CT scan revealed CTS with left anomalous pulmonary venous drainage. The left pulmonary vein (PV) was draining into the innominate vein via the vertical vein (VV), as well as into the accessory left atrial (LA) chamber via a narrow common pulmonary venous collector (CPVC). He was diagnosed with CTS as a subtype of Lucas–Schmidt classification III A2 (Fig. 1). On hospital day 2, transthoracic echocardiography revealed a significantly dilated right portion of the heart and a severely obstructive fibromuscular membrane between the two LA chambers (mean pressure gradient 6.2 mmHg); this membrane contained a hole 2.9 mm in diameter. The atrial septal defect (ASD) was likewise restrictive with a diameter of about 2 mm (type A2 Lam classification [8]). The CPVC between the VV and the accessory LA chamber was as narrow as 2.9 mm in places. On the other hand, the VV was comp
Data Loading...
