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Yedurupaka SS, Raj BSS, Prasad RMV. Ischemic Heart Disease with In-Stent Re-Stenosis with Complete Heart Block and Isolated Persistent Left Superior Vena Cava - Rare Case Report with Challenges and Clinical Implications. Ann Card Anaesth 2024; 27:270-273. [PMID: 38963367 PMCID: PMC11315249 DOI: 10.4103/aca.aca_166_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/11/2024] [Accepted: 01/24/2024] [Indexed: 07/05/2024] Open
Abstract
ABSTRACT Isolated persistent left superior vena cava (PLSVC) is a very rare congenital thoracic venous system anomaly and is commonly an incidental finding, usually detected during central venous access, cardiac catheterization, or cardiothoracic surgeries. This is a rare case report wherein the patient is a known case of ischemic heart disease with s/p percutaneous transluminal coronary angioplasty (PTCA) with a stent to left anterior descending (LAD) artery with in-stent re-stenosis presented with complete heart block and had an unanticipated discovery of isolated PLSVC on facing difficulty during the transvenous approach of permanent pacemaker implantation (PPI). In this case report, we inspect the challenges associated with and various clinical implications of isolated PLSVC.
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Affiliation(s)
- Santhi Sree Yedurupaka
- Department of Anesthesiology, NRI Medical College and General Hospital, Chinakakani, Andhra Pradesh, India
| | - B Sanjay Soloman Raj
- Department of Cardiac Anesthesiology, NRI Medical College and General Hospital, Chinakakani, Andhra Pradesh, India
| | - R Maruthi Vara Prasad
- Department of Cardiovascular and Thoracic Surgery, NRI Medical College and General Hospital, Chinakakani, Andhra Pradesh, India
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Hata T, Kato K, Kamiya K, Okuyama Y, Fujii Y, Yagi N, Ozawa T, Nakagawa Y. Persistent Left Superior Vena Cava with the Absence of the Right Superior Vena Cava and Atrial Appendage: Complex Pacemaker Implantation in a Patient Presenting with a Rare Vascular Anomaly. Intern Med 2024; 63:1373-1376. [PMID: 37743512 PMCID: PMC11157321 DOI: 10.2169/internalmedicine.2391-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/08/2023] [Indexed: 09/26/2023] Open
Abstract
A persistent left superior vena cava (PLSVC) is a commonly observed anatomical anomaly that is frequently detected incidentally via computed tomography (CT) imaging. However, the occurrence of a PLSVC with a right superior vena cava (RSVC) defect, also known as "isolated PLSVC," is a much rarer anomaly. This peculiar malformation can lead to sinoatrial dysfunction, thus necessitating pacemaker implantation, which requires delicate manipulation due to various anatomical complexities. We herein present a case of a sick sinus syndrome with this rare anomaly, which required special consideration when performing pacemaker lead placement.
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Affiliation(s)
- Toshika Hata
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Japan
| | - Koichi Kato
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Japan
| | - Kenichi Kamiya
- Depatment of Cardiovascular Surgery, Shiga University of Medical Science, Japan
| | - Yusuke Okuyama
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Japan
| | - Yusuke Fujii
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Japan
| | - Noriaki Yagi
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Japan
| | - Tomoya Ozawa
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Japan
| | - Yoshihisa Nakagawa
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Japan
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Copeland H, Knezevic I, Baran DA, Rao V, Pham M, Gustafsson F, Pinney S, Lima B, Masetti M, Ciarka A, Rajagopalan N, Torres A, Hsich E, Patel JK, Goldraich LA, Colvin M, Segovia J, Ross H, Ginwalla M, Sharif-Kashani B, Farr MA, Potena L, Kobashigawa J, Crespo-Leiro MG, Altman N, Wagner F, Cook J, Stosor V, Grossi PA, Khush K, Yagdi T, Restaino S, Tsui S, Absi D, Sokos G, Zuckermann A, Wayda B, Felius J, Hall SA. Donor heart selection: Evidence-based guidelines for providers. J Heart Lung Transplant 2023; 42:7-29. [PMID: 36357275 PMCID: PMC10284152 DOI: 10.1016/j.healun.2022.08.030] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 01/31/2023] Open
Abstract
The proposed donor heart selection guidelines provide evidence-based and expert-consensus recommendations for the selection of donor hearts following brain death. These recommendations were compiled by an international panel of experts based on an extensive literature review.
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Affiliation(s)
- Hannah Copeland
- Department of Cardiovascular and Thoracic Surgery Lutheran Hospital, Fort Wayne, Indiana; Indiana University School of Medicine-Fort Wayne, Fort Wayne, Indiana.
| | - Ivan Knezevic
- Transplantation Centre, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - David A Baran
- Department of Medicine, Division of Cardiology, Sentara Heart Hospital, Norfolk, Virginia
| | - Vivek Rao
- Peter Munk Cardiac Centre Toronto General Hospital, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada
| | - Michael Pham
- Sutter Health California Pacific Medical Center, San Francisco, California
| | - Finn Gustafsson
- Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Sean Pinney
- University of Chicago Medicine, Chicago, Illinois
| | - Brian Lima
- Medical City Heart Hospital, Dallas, Texas
| | - Marco Masetti
- Heart Failure and Heart Transplant Unit IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Agnieszka Ciarka
- Department of Cardiovascular Diseases, Katholieke Universiteit Leuven, Leuven, Belgium; Institute of Civilisation Diseases and Regenerative Medicine, University of Information Technology and Management, Rzeszow, Poland
| | | | - Adriana Torres
- Los Cobos Medical Center, Universidad El Bosque, Bogota, Colombia
| | | | | | | | | | - Javier Segovia
- Cardiology Department, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Madrid, Spain
| | - Heather Ross
- University of Toronto, Toronto, Ontario, Canada; Sutter Health California Pacific Medical Center, San Francisco, California
| | - Mahazarin Ginwalla
- Cardiovascular Division, Palo Alto Medical Foundation/Sutter Health, Burlingame, California
| | - Babak Sharif-Kashani
- Department of Cardiology, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - MaryJane A Farr
- Department of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Luciano Potena
- Heart Failure and Heart Transplant Unit IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | | | | | | | | | | | - Valentina Stosor
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Kiran Khush
- Division of Cardiovascular Medicine, Stanford University, Stanford, California
| | - Tahir Yagdi
- Department of Cardiovascular Surgery, Ege University School of Medicine, Izmir, Turkey
| | - Susan Restaino
- Division of Cardiology Columbia University, New York, New York; New York Presbyterian Hospital, New York, New York
| | - Steven Tsui
- Department of Cardiothoracic Surgery Royal Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom
| | - Daniel Absi
- Department of Cardiothoracic and Transplant Surgery, University Hospital Favaloro Foundation, Buenos Aires, Argentina
| | - George Sokos
- Heart and Vascular Institute, West Virginia University, Morgantown, West Virginia
| | - Andreas Zuckermann
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Brian Wayda
- Division of Cardiovascular Medicine, Stanford University, Stanford, California
| | - Joost Felius
- Baylor Scott & White Research Institute, Dallas, Texas; Texas A&M University Health Science Center, Dallas, Texas
| | - Shelley A Hall
- Texas A&M University Health Science Center, Dallas, Texas; Division of Transplant Cardiology, Mechanical Circulatory Support and Advanced Heart Failure, Baylor University Medical Center, Dallas, Texas
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Gallardo MEA. Giant Rasmussen's aneurysm in a 9-year-old boy: A case report. Radiol Case Rep 2022; 17:4168-4175. [PMID: 36105835 PMCID: PMC9464773 DOI: 10.1016/j.radcr.2022.08.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/02/2022] Open
Abstract
Rasmussen's aneurysm is a pseudoaneurysm caused by tuberculosis, when cavitation occurs adjacent to a pulmonary artery, which can be lethal. It is a rare complication usually affecting adults. This is a case of an 9-year-old boy initially admitted for pneumonia that developed hemoptysis during admission. Chest X-ray done after this episode showed development of a left hilar mass not present in the previous studies. A chest CT with contrast subsequently revealed a saccular aneurysm arising from the left lower lobe pulmonary artery adjacent to a cavity, a Rasmussen's aneurysm. The patient was treated conservatively with continuation of anti-TB medication and serial monitoring due to the size of the aneurysm being less than 6 cm and spontaneous resolution of the hemoptysis. This report stresses that a Rasmussen's aneurysm should always be in the differential diagnosis of a hilar mass in a patient with hemoptysis, regardless of the patient's age.
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Verma M, Pandey NN, Ojha V, Kumar S. Persistent left superior vena cava with absent right superior vena cava in the setting of viscero-atrial situs solitus: a rare systemic venous drainage. Acta Cardiol 2021; 76:918-919. [PMID: 32705930 DOI: 10.1080/00015385.2020.1796033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Mansi Verma
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Niraj Nirmal Pandey
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Vineeta Ojha
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sanjeev Kumar
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Hayashi T, Murakami M, Saito S. Absent right superior vena cava. J Gen Fam Med 2021; 22:223-224. [PMID: 34221798 PMCID: PMC8245746 DOI: 10.1002/jgf2.419] [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: 11/26/2020] [Revised: 12/22/2020] [Accepted: 01/05/2021] [Indexed: 11/08/2022] Open
Abstract
A patient planned to be performed catheter ablation. However, three-dimensional contrast-enhanced chest computed tomography revealed isolated persistent left superior vena cava. We should know such an anatomical abnormality especially when central venous catheter or peripherally inserted central catheter is inserted from right jugular vein or right subclavian vein.
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Affiliation(s)
- Takahiro Hayashi
- Department of Cardiology Shonan Kamakura General Hospital Kamakura Japan
| | - Masato Murakami
- Department of Cardiology Shonan Kamakura General Hospital Kamakura Japan
| | - Shigeru Saito
- Department of Cardiology Shonan Kamakura General Hospital Kamakura Japan
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Aihole JS. Persistent Left Superior Vena Cava: A Rare Association. Glob Pediatr Health 2021; 8:2333794X211015527. [PMID: 34104691 PMCID: PMC8150421 DOI: 10.1177/2333794x211015527] [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: 03/11/2021] [Accepted: 04/15/2021] [Indexed: 11/16/2022] Open
Abstract
Persistent left superior vena cava (PLSVC) is the most frequent abnormality in the general population with the frequency of 0.1% to 0.5%. It results from the failure of the involution of the left anterior cardinal vein. Right and Left SVC can coexist together in 80% to 90% of cases. Association of PLSVC with ano rectal malformation (ARM) is very rarely reported. Hence, here is a report of a unique case of PLSVC in a female neonate with ARM.
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Trostler MS, Planinsic RM. Persistent Left Superior Vena Cava—When a Left-Sided Central Line Does Not Make the Turn: A Case Report. Semin Cardiothorac Vasc Anesth 2021; 25:239-241. [DOI: 10.1177/1089253221998551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A 59-year-old male presenting for a living nonrelated kidney transplant has an intraoperative left internal jugular central venous catheter placed for operative access and monitoring. Post-anesthesia care unit postoperative chest X-ray shows possible aortic placement as read by radiology. The catheter is confirmed venous on insertion, with monitoring during the operation, and with repeat transduction and venous blood gas results postoperatively. A follow-up computed tomography scan shows findings consistent with persistent left superior vena cava. This can be associated with other cardiac abnormalities and an increased risk of complications, both mechanical and physiological. Care should be taken in patients identified with persistent left superior vena cava to prevent complications in future procedures.
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Verma M, Pandey NN, Ojha V, Kumar S, Ramakrishnan S. Developmental anomalies of the superior vena cava and its tributaries: What the radiologist needs to know? Br J Radiol 2021; 94:20200856. [PMID: 33197326 DOI: 10.1259/bjr.20200856] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Deviations from the normal process of embryogenesis can result in various developmental anomalies of the superior vena cava (SVC). While these anomalies are often asymptomatic, they assume clinical importance during interventions such as central venous catheterisations and pacemaker implantations and during cardiothoracic surgeries while instituting cardiopulmonary bypass and for creation of cavo-pulmonary connections. Role of imaging in identifying these anomalies is indispensable. Cross-sectional imaging techniques like CT venography and magnetic resonance (MR) venography allow direct visualisation and consequently increased detection of anomalies. CT venography plays an important role in detection of SVC anomalies as it is readily available, has excellent spatial resolution, short acquisition times and potential for reconstruction of images in multiple planes. This pictorial review focuses on the developmental anomalies of the SVC and its tributaries highlighting their embryological basis, imaging appearances on CT venography and potential clinical implications, where relevant.
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Affiliation(s)
- Mansi Verma
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
| | - Niraj Nirmal Pandey
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
| | - Vineeta Ojha
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjeev Kumar
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
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Acherman RJ, Evans WN, Restrepo H. Prenatal Diagnosis of Absent Right Superior Vena Cava in Referrals for Fetal Echocardiography. JOURNAL OF FETAL MEDICINE 2021. [DOI: 10.1007/s40556-020-00279-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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11
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Puspitasari M, Sinorita H, Bagaswoto HP, Kuswadi I, Prasanto H, Wardhani Y, Kurniawan WT. Persistent Left Superior Vena Cava Identified After Hemodialysis Catheter Insertion: A Case Report. Int Med Case Rep J 2020; 13:465-469. [PMID: 33061669 PMCID: PMC7534844 DOI: 10.2147/imcrj.s266858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/22/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Central venous catheter (CVC) insertion is the most commonly performed clinical procedure when a patient initiates hemodialysis. Despite its clinical benefits, CVC insertion has several risks of complications. Thrombosis, venous stenosis, infection, arrhythmia, pneumothorax, and bleeding are among these complications. Malposition of the tip of the CVC can also occur with an incidence of up to 7%. One of several factors that could contribute to malposition is venous anatomy variation. Persistent left superior vena cava (PLSVC) is an extremely rare venous anatomical disorder but might have a significant clinical impact. Case Presentation Here we report a PLSVC case that was identified in chest radiography after the insertion of a CVC catheter in a patient with end-stage renal disease (ESRD). A 40-year-old woman with a history of type 2 diabetes mellitus, hypertension, dyslipidemia, and obesity was presented in the emergency room with dyspnea for 1 week. Acute hemodialysis was required because of the ESRD and pulmonary edema. The PLSVC condition accompanied by various complications that occurred in this patient became a dilemma for the nephrologist in determining the diagnosis and proper CVC management. Discussion PLSVC is the most common congenital abnormality of the vena cava, even though it has a very small incidence. PLSVC occurs in about 0.1–0.5% of the total population and reaches 10% in individuals with congenital heart abnormalities. Most PLSVC presents along with normal superior vena cava and drains into the right atrium, which makes it very difficult to see the clinical signs and symptoms. Almost all PLSVC conditions are found incidentally during or after invasive procedures such as CVC insertion. CVC insertion in the PLSVC condition needs proper management to minimize the risk of complications. Conclusion This case shows the importance of understanding the PLSVC condition, which, although very rare, is expected to increase the awareness of the nephrologist in making the diagnosis, determining appropriate management, and preventing complications, thereby improving patient safety.
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Affiliation(s)
- Metalia Puspitasari
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Hemi Sinorita
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Hendry Purnasidha Bagaswoto
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Iri Kuswadi
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Heru Prasanto
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Yulia Wardhani
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Wahyu Tri Kurniawan
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia
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Persistent left superior vena cava with absent right superior vena cava in adults: CT and clinical findings. Jpn J Radiol 2020; 38:1046-1051. [PMID: 32666181 DOI: 10.1007/s11604-020-01013-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/23/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Persistent left superior vena cava (PLSVC) with absent right superior vena cava (ARSVC) is rare. We evaluated CT and clinical findings of adults with ARSVC. MATERIALS AND METHODS Our study included 11 adults with ARSVC (mean age, 63 ± 17 years). We evaluated CT findings of the azygos vein system and coronary sinus (CS) using thin slice data of > 64 MDCT. Arrhythmia and congenial heart disease were assessed. We compared the CS diameters between the ARSVC group and the control group of 120 adults with normal vena cava (mean age, 60 ± 4 years). RESULTS Adults with ARSVC had no azygos vein arch and the hemiazygos vein continued to PLSVCs via the superior intercostal vein. Eight adults had arrhythmia including conduction disturbance and one arrhythmia was associated with atrial septal defect. All adults with ARSVC had dilated CS larger than 11 mm. The mean diameter of the CS in the ARSVC group was 18.4 mm, and that of the control group was 6.8 mm. CS diameter in the ARSVC group was larger than that in the control group (p < 0.001). CONCLUSION Adults with ARSVC had dilated CS and no azygos vein arch. Four adults had conduction disturbance.
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Sylwestrzak O, Respondek-Liberska M. Gradual diagnosis and clinical importance of prenatally detected persistent left superior vena cava with absent right superior vena cava - a case report and literature review. J Ultrason 2020; 20:e146-e150. [PMID: 32609967 PMCID: PMC7409560 DOI: 10.15557/jou.2020.0023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 03/30/2020] [Indexed: 11/29/2022] Open
Abstract
Persistent left superior vena cava is a malformation of cardinal veins. We report a case of a secundigravida who had many fetal ultrasound examinations – first performed by an obstetrician (who described fetal mediastinum as “abnormal”), second by other obstetrician, who performed basic fetal echocardiographic examination and diagnosed persistent left superior vena cava. The woman was referred to a tertiary center for detailed fetal echocardiography. The diagnosis of persistent left superior vena cava with agenesis of the right superior vena cava was confirmed. The anomaly had no influence on fetal hemodynamic stability, fetal life, delivery and early postnatal period. After delivery, the neonate was under observation for further anomalies, aortic coarctation in particular. Prenatal and postnatal management was summarized. Literature review is presented.
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Affiliation(s)
- Oskar Sylwestrzak
- Medical Faculty, Medical University of Lodz , Lodz , Poland ; Department for Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute , Lodz , Poland
| | - Maria Respondek-Liberska
- Department for Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute , Lodz , Poland ; Department for Congenital Malformations and Prevention, Faculty of Public Health, Medical University of Lodz , Poland
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Shoiab I, Schaff H, Saran N, Charnin J, Ritter M. Recommendations for Perioperative Management in Patients With Absent Right Superior Vena Cava. J Cardiothorac Vasc Anesth 2018; 33:1710-1713. [PMID: 30219642 DOI: 10.1053/j.jvca.2018.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Irsa Shoiab
- Department of Cardiothoracic Surgery, Mayo Clinic, Rochester, MN.
| | - Hartzell Schaff
- Department of Cardiothoracic Surgery, Mayo Clinic, Rochester, MN
| | - Nishant Saran
- Department of Cardiothoracic Surgery, Mayo Clinic, Rochester, MN
| | | | - Matthew Ritter
- Department of Anesthesiology, Mayo Clinic, Rochester, MN
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15
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Modification of surgical approach and cannulation strategy for mitral valve repair after intraoperative diagnosis of persistent left superior vena cava. J Clin Anesth 2018; 52:80-81. [PMID: 30218887 DOI: 10.1016/j.jclinane.2018.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 08/23/2018] [Accepted: 09/08/2018] [Indexed: 11/22/2022]
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16
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Bulsara SS, Paliwal V, Prasad G, Bharath M, Sahu T, Sheorain V, Grover T, Parakh R. Vascular access in a rare case of 'isolated-persistent left superior vena cava'. J Vasc Access 2018; 19:409-410. [PMID: 29552928 DOI: 10.1177/1129729817748128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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17
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Reyes KM, Gupta D, Fricker FJ, Cooke S, Bleiweis MS. Heart Transplant in Patient With Isolated Left Superior Vena Cava by Atrial Appendage Rotation. Ann Thorac Surg 2018; 105:e279-e281. [PMID: 29410126 DOI: 10.1016/j.athoracsur.2018.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/26/2017] [Accepted: 01/03/2018] [Indexed: 11/28/2022]
Abstract
Orthotopic heart transplantation in patients with an isolated persistent left superior vena cava is extremely rare, and the anastomotic connection between a right-sided donor superior vena cava and left-sided recipient superior vena cava can be challenging to perform. We present a novel technique used in an infant female, using the left atrial appendage to extend the superior vena cava anastomosis.
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Affiliation(s)
- Karl M Reyes
- Congenital Heart Center, Departments of Surgery and Pediatrics, University of Florida-Shands Children's Hospital, Gainesville, Florida.
| | - Dipankar Gupta
- Congenital Heart Center, Departments of Surgery and Pediatrics, University of Florida-Shands Children's Hospital, Gainesville, Florida
| | - Frederick Jay Fricker
- Congenital Heart Center, Departments of Surgery and Pediatrics, University of Florida-Shands Children's Hospital, Gainesville, Florida
| | - Susan Cooke
- Congenital Heart Center, Departments of Surgery and Pediatrics, University of Florida-Shands Children's Hospital, Gainesville, Florida
| | - Mark S Bleiweis
- Congenital Heart Center, Departments of Surgery and Pediatrics, University of Florida-Shands Children's Hospital, Gainesville, Florida
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Lampropoulos K, Giannoulis E, Bazoukis G, Tse G, Triantafyllou E, Triantafyllou A. Reversible Stress Cardiomyopathy Secondary to Aneurysmal Subarachnoid Hemorrhage: A Case Report. J Emerg Med 2017; 53:e129-e131. [PMID: 28993037 DOI: 10.1016/j.jemermed.2017.08.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 07/23/2017] [Accepted: 08/11/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Acute cerebral incidents have been correlated with cardiac manifestations. Specifically, subarachnoid hemorrhage has been correlated with a syndrome described as neurogenic stress cardiomyopathy and mimics acute coronary syndrome. CASE REPORT A 55-year-old woman presented at the Emergency Department of our hospital complaining of vomiting and headache of sudden onset. Computed tomography angiography revealed a ruptured aneurysm at the tip of the basilar artery and the patient underwent a successful complete embolism of the sac of the aneurysm. During hospitalization, the patient developed electrocardiographic alterations and elevation of cardiac biomarkers, and echocardiography showed an impairment of left ventricular systolic function. The patient was diagnosed with neurogenic stress cardiomyopathy and she was treated conservatively. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Clinicians should be aware of neurogenic stress cardiomyopathy because early diagnosis and treatment are the cornerstones for achieving a better outcome.
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Affiliation(s)
| | - Evangelos Giannoulis
- Department of Cardiology, General Hospital of Athens "Evangelismos", Athens, Greece
| | - George Bazoukis
- Department of Cardiology, General Hospital of Athens "Evangelismos", Athens, Greece
| | - Gary Tse
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, SAR, P.R. China
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Pardinas Gutierrez MA, Escobar LA, Blumer V, Cabrera JL. Incidental finding of persistent left superior vena cava after 'bubble study' verification of central venous catheter. BMJ Case Rep 2017; 2017:bcr-2017-220133. [PMID: 28765490 DOI: 10.1136/bcr-2017-220133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We report a case of a patient with septic shock who underwent central venous catheter placement in the left internal jugular vein, and a bedside ultrasound 'bubble study' revealed venous cannulation. A chest X-ray postprocedure revealed concern for arterial system catheterisation. However, the possibility of a persistent left superior vena cava was discussed and confirmed with a formal transthoracic echocardiogram and CT. This case demonstrates the importance of ultrasound-guided visualisation of anatomical structures in real time during central venous catheterisation. Other similar cases from the literature are briefly described.
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Affiliation(s)
| | - Luis A Escobar
- Department of Medicine, Jackson Memorial Hospital, Miami, Florida, USA
| | - Vanessa Blumer
- Department of Medicine, Jackson Memorial Hospital, Miami, Florida, USA
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Cardiac Arrhythmias in Patient with Isolated Persistent Left Superior Vena Cava. CURRENT HEALTH SCIENCES JOURNAL 2017; 43:163-166. [PMID: 30595873 PMCID: PMC6284175 DOI: 10.12865/chsj.43.02.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 06/15/2017] [Indexed: 11/18/2022]
Abstract
We report here the case of a 47-year-old male presented with atypical chest pain, fatigue and arrhythmias that was found to have persistent left superior vena cava. The clinical exam was normal. Twelve leads ECG showed sinus rhythm of 70 beats/min, QRS axis of 90 degree and right bundle branch block. Transthoracic echocardiography revealed left ventricular hypertrophy, a large coronary sinus and mild pulmonary hypertension. Saline contrast echocardiography was performed and micro-bubbles were visible first into the coronary sinus and then passed through the right atrium. Multislice computed tomography confirmed the presence of persistent left superior vein cava and the site of drainage into the right atrium via a large coronary sinus. Right superior vein cava was absent. In this case report, we emphasize the importance of full assessment in patient with persistent left superior vena cava.
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Inability to Utilize Retrograde Cardioplegia due to a Persistent Left Superior Vena Cava. Case Rep Anesthesiol 2017; 2017:4671856. [PMID: 29333298 PMCID: PMC5733155 DOI: 10.1155/2017/4671856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 10/16/2017] [Accepted: 11/05/2017] [Indexed: 01/07/2023] Open
Abstract
A persistent left superior vena cava is a congenital abnormality that affects a minority of the general population. While this finding is not hemodynamically significant in all patients, failure to recognize the altered anatomy in any of these patients can be consequential during procedures such as central venous catheter placement, pacemaker/defibrillator wire placement, and use of retrograde cardioplegia during cardiac surgery. We present a case of an intraoperative diagnosis of a persistent left superior vena cava that altered the original plan to arrest the heart using retrograde cardioplegia. Echocardiography was instrumental in this diagnosis and avoided potentially inadequate myocardial protection during cardiopulmonary bypass.
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