Atrial septal defect closure complicated by anomalous inferior vena cava return to the left atrium: a case report of a 5-year-old child

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Abstract

Background

The anatomy of the sinus venosus atrial septal defect (ASD) of the inferior vena caval type is complex. Limited rate of complications during its closure has been described. One of the unusual complications, with few case reports, is the iatrogenic diversion of the inferior vena cava (IVC) to the left atrium (LA).

Case summary

We report the case of a 5-year-old boy who underwent previous surgical closure of sinus venosus ASD of the inferior vena caval type aged 2 years. Three years after surgery, he was diagnosed as having iatrogenic diversion of the IVC to the LA.

Discussion

Cardiologists and cardiac surgeons should be aware of this rare but significant complication following routine ASD surgical repair and vigilant follow-up should be performed routinely.

Related collections

Most cited references 12

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Residual right-to-left shunt following repair of atrial septal defect.

Doss Neal, J Möller, A Nicoloff … (1976)

Information about 5 patients with residual right-to-left shunts following repair of an atrial septal defect is presented. In each patient the defect was located low in the atrial septum adjacent to the inferior vena cava. During operation, either the eustachian valve of the inferior vena cava had been mistaken for the lower margin of the defect or the lower portion of the defect was not closed; blood flow was then diverted from the inferior vena cava into the left atrium. To prevent this occurrence, the inferior margin of the atrial septal defect should be closed first.

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Iatrogenic cyanosis and clubbing: 25 years of chronic hypoxia after the repair of an atrial septal defect.

Judith Therrien, Ariane J Marelli, Muath Alanbaei … (2007)

A case of sinus venosus atrial septal defect repair of the inferior vena caval type with an unintentional diversion of the inferior vena caval blood to the left atrium is reported. Long-standing, anatomical, right-to-left shunting with cyanosis and hypoxia are associated with systemic and cerebrovascular complications. Cardiac risks depend on the presence or absence of pulmonary hypertension, the associated hematological abnormalities and the degree of anatomical, right-to-left shunting. Cardiac magnetic resonance imaging clarified the etiology of the unexplained cyanosis and delineated the surgical anatomy.

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Is Open Access

Iatrogenic diversion of IVC to left atrium after surgical closure of ASD

Shreepal A Jain, Robin Pinto, Bharat Dalvi (2012)

Iatrogenic diversion of the inferior vena cava (IVC) to the left atrium during surgical closure of an atrial septal defect (ASD) is a very rare complication in the era of cardiopulmonary bypass. The eustachian valve could be mistaken for the margin of the ASD. We report a case with this complication after closure of a sinus venosus ASD of the IVC type.

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Author and article information

Contributors

Tor Biering-Sørensen: Role: Handling Editor

George Giannakoulas: Role: Editor

Cemil Izgi: Role: Editor

Francesca Musella: Role: Editor

Mohammed Akhtar: Role: Editor

Peysh A Patel: Role: Editor

Journal

Journal ID (nlm-ta): Eur Heart J Case Rep

Journal ID (iso-abbrev): Eur Heart J Case Rep

Journal ID (publisher-id): ehjcr

Title: European Heart Journal: Case Reports

Publisher: Oxford University Press

ISSN (Electronic): 2514-2119

Publication date Collection: June 2019

Publication date (Electronic): 24 May 2019

Publication date PMC-release: 24 May 2019

Volume: 3

Issue: 2

Electronic Location Identifier: yty169

Affiliations

Pediatric Cardiology Department, American University of Beirut, 6th Floor, Room # 688 Cairo Street, Hamra, Beirut, Lebanon

Author notes

Corresponding author. Tel: +961 1 350000 (ext 5748), Fax: +961 1 370 781, Email: ma81@ 123456aub.edu.lb

Article

Publisher ID: yty169

DOI: 10.1093/ehjcr/yty169

PMC ID: 6601233

SO-VID: bed5aa74-d037-40fb-80b4-cab2cc2b717c

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

History

Date received : 08 August 2018

Date accepted : 16 May 2019

Page count

Pages: 4

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