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Liu D, Wu T, Wang Y, Dian K, Liu H, He X, Chen J. Persistent right venous valve as a cause of fetal and neonatal pathology from prenatal to postnatal periods: a case report and review. Cardiovasc Diagn Ther 2023; 13:1118-1127. [PMID: 38162111 PMCID: PMC10753248 DOI: 10.21037/cdt-23-288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 10/27/2023] [Indexed: 01/03/2024]
Abstract
Background Neonatal cyanosis is a clinical manifestation of hypoxemia and is usually pathological. Persistent right venous valve (PRVV) is a rare cause of cyanosis in newborns and can cause prenatal abnormalities, the clinical significance of which varies depending on the severity of the abnormality. There have been few reports on the intrauterine detection of these abnormalities and their follow-up during infancy. Here, we report a case of PRVV causing supravalvular tricuspid valve (TV) obstruction and secondary right ventricle (RV) hypoplasia. This case is unique in terms of its early prenatal detection, distinct cardiac anomalies, and successful surgery that reversed the symptoms, and the findings offer insights into the diagnosis and management of such rare cardiac conditions. Case Description We report a case of a newborn diagnosed with PRVV at 31 weeks of gestation at our center. There was no underlying family history of congenital heart disease. Prenatal sonography identified an echogenic membrane in the right atrium, suggesting TV obstruction and subsequent RV hypoplasia. After birth, the neonate suffered hypoxia with decreased arterial oxygen saturation (SaO2). Minimally invasive surgery successfully corrected the membrane. Postoperative SaO2 improved immediately. Three months later, follow-up echocardiography revealed normalized TV and RV dimensions. The patient demonstrated steady progress without any complications. We also reviewed previous cases of PRVV before and after birth and summarized the sonographic and clinically relevant features. Conclusions Although PRVV is typically considered as a benign structure, it may lead to significant clinical complications, particularly in fetuses and neonates. The precise identification of its variant forms and related flow patterns is crucial to inform decisions regarding patient management.
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Affiliation(s)
- Dan Liu
- Department of Ultrasonic Medicine, West China Second University Hospital of Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu, China
| | - Ting Wu
- Department of Ultrasonic Medicine, West China Second University Hospital of Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu, China
| | - Yu Wang
- Department of Ultrasonic Medicine, West China Second University Hospital of Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu, China
| | - Ke Dian
- Department of Cardiovascular Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Hanmin Liu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu, China
- Department of Pediatric Pulmonology and Immunology, West China Second University Hospital of Sichuan University, Chengdu, China
- Key Laboratory of Chronobiology (Sichuan University), National Health Commission of China, Chengdu, China
- The Joint Laboratory for Lung Development and Related Diseases of West China Second University Hospital, Sichuan University and School of Life Sciences of Fudan University, West China Institute of Women and Children’s Health, West China Second University Hospital of Sichuan University, Chengdu, China
- Sichuan Birth Defects Clinical Research Center, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Xiaolan He
- Ziyang Maternal and Child Health Care Hospital, Ziyang, China
- Ziyang Women and Children Hospital, West China Second University Hospital of Sichuan University, Ziyang, China
| | - Jiao Chen
- Department of Ultrasonic Medicine, West China Second University Hospital of Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu, China
- Department of Ultrasonic Medicine, Tibet Autonomous Region Women’s and Children’s Hospital, Lhasa, China
- Tibet Autonomous Region Women’s and Children’s Hospital, West China Second University Hospital of Sichuan University, Lhasa, China
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Mapelli M, Zagni P. Editorial: An International Journey into the Research Progress of Pediatric Cardiology. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020321. [PMID: 36832450 PMCID: PMC9955689 DOI: 10.3390/children10020321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Abstract
The first time we met was in the pediatric ward of St [...].
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Affiliation(s)
- Massimo Mapelli
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy
- Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, 20122 Milan, Italy
- Correspondence: ; Tel.: +39-0258002930
| | - Paola Zagni
- Terapia Intensiva Neonatale, Ospedale Fatebenefratelli P.O. Macedonio Melloni, Via Macedonio Melloni 52, 20129 Milan, Italy
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