alexa Total Anomalous Systemic Venous Drainage to the Left Atrium: A Rare Case of Left Atrial Hysomerism without Intra-Cardiac Defect | OMICS International
ISSN: 2329-6925
Journal of Vascular Medicine & Surgery
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Total Anomalous Systemic Venous Drainage to the Left Atrium: A Rare Case of Left Atrial Hysomerism without Intra-Cardiac Defect

Del Gaizo F*, Caiainiello G, Palladino MT, Santoro G and Russo MG

Department of Pediatric Cardiology and of Pediatric Cardiac Surgery, AORN dei Colli Monaldi Hospital, Naples, Italy

*Corresponding Author:
Del Gaizo F
Department of Pediatric
Cardiology and of Pediatric Cardiac Surgery
AORN dei Colli Monaldi Hospital, Naples, Italy
Tel: 0393382565187
E-mail: [email protected]

Received Date: November 27, 2014; Accepted Date: January 22, 2015; Published Date: January 24, 2015

Citation: Del Gaizo F, Caiainiello G, Palladino MT, Santoro G, Russo MG (2015) Total Anomalous Systemic Venous Drainage to the Left Atrium: A Rare Case of Left Atrial Hysomerism without Intra-Cardiac Defect. J Vasc Med Surg 3:172. doi:10.4172/2329-6925.1000172

Copyright: © 2015 Gaizo FD, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Keywords

Coronary sinus; Vena cava superior; Echocardiography

Introduction

Total anomalous systemic venous return is a very rare malformation, where the vena cava inferior (IVC), the vena cava superior (SVC), and coronary sinus drain into left atrium. In this case, we report an anomaly characterized by a left atrial isomerism with anomalous drainage of IVC, SVC, SSVC, and coronary sinus into left atrium in a small female-baby.

Case Report

We reported the history of S. She received fetal diagnosis of “total anomalous systemic venous connection TASVC and persistent left superior vena cava draining to left atrium"

Personal history

She was born at 38°w, weight kg 2.860, she was cianotyc at birth (oxymetry sat. about 70%). At 3 days of life she was submitted to an external echocardiography (Figure 1 ) and a cardiac catheterization , at our Paediatric Cardiology, which showed situs visceral solitus and left anatomical conformation of both atria and confirmed TASVC (Figures 2-4).

vascular-medicine-surgery-two-dimensional-coronal

Figure 1: Two-dimensional (2D) echocardiography with substernal coronal view showing the relationship of the aorta and inferior vena cava (IVC) suggestive of left isomerism

vascular-medicine-surgery-conformation-rvcs

Figure 2: Conformation of RVCS

vascular-medicine-surgery-conformation-vci

Figure 3: Confirmation of VCI

vascular-medicine-surgery-conformation-ssvc

Figure 4: Confirmation of SSVC

Surgery intervention

At 4 days of life we performed a surgical intervention with atrial septostomy a and outpatient clinical observations report perioral cyanosis, oxymetry sat was 80% and adequate atrial blood mixing at echocardiography. During months we observed the patient with no clinic variations.

When she was 10 months old, she was exposed to a surgical atrial septal reconstruction with bovine pericardial patch draining the vena cava to the right side, she received a hypothermic CEC and a Custodiol Cardioplegia (Figure 5 and 6).

vascular-medicine-surgery-surgical-view-ivc-svc-ssvc

Figure 5: Surgical view of IVC, SVC, SSVC

vascular-medicine-surgery-patch-draining-vena

Figure 6: Patch draining the vena

Follow up

During the Postoperative she was subjected to echocardiographic controls and electrocardiograms. Echocardiography controls showed a good surgical outcome and small septal defect with L-R shunt, the electrocardiograms observed a postoperative complication whit junctional rhythm, confirmed by 24-hour Holter. After surgical intervention she took therapy with Cardioaspirin for 6 months.

Conclusion

S. is now a 15 months old little girl in good clinical conditions (oxymetry sat. 85%), echocardiography controls confirmed a good surgical outcome and there were no further arrhythmias evaluated with Holter.

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