A Rare Pulmonary-Systemic Connection: Levoatriocardinal Vein (original) (raw)
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A Rare Pathology: The Levoatriocardinal Vein
Turk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society of Cardiology, 2015
Levoatriocardinal vein (LACV) is a rare cardiac pathology that represents a connection between the pulmonary venous and cardinal systems. The aim of the present study was to discuss morphological and clinical characteristics, as well as diagnostic methods, of experience with LACV. Methods: Records of 11 patients (4 male, 7 female; mean age 79±1.83 days; range 1-390 days) diagnosed with LACV between 2010 and 2014 were retrospectively reviewed. Presence of LACV was confirmed with echocardiography. The primary obstructive lesion associated with cardiac defects and the integrity of the interatrial septum was identified in each patient with left-sided obstruction. Results: Mean weight was 4.4±0.4 kg (range: 2-8). Age at presentation was under 1 year in 82% of patients. Nine patients had left-sided obstruction, and 2 had normal intracardiac anatomy and pulmonary venous return. In patients with left-sided obstruction, LACV was initially demonstrated with echocardiographic evaluation, performed in apical 4-chamber, high parasternal, and subcostal views. Atrial septum was restrictive or intact in patients with left-sided obstructions. LACV originated directly from the left atrium in all patients. Conclusion: Levoatriocardinal vein is an extremely rare cardiac pathology, presenting almost exclusively in patients with left-sided obstructive lesions. In patients with left-sided obstructions, LACV must be kept in mind. It may also present in patients with normal intracardiac anatomy and pulmonary venous return.
2017
A persistent Left Superior Vena Cava (LSVC) is a relatively common, quiescent congenital anomaly in the general population, often with drainage into the coronary sinus and return to the right atrium. We present a rare case of persistent LSVC with connection to the Left Upper Pulmonary Vein (LUPV), creating potential for right-to-left shunting, in the absence of other congenital anatomical anomalies. This connection can result in cyanosis, increased risk for endocarditis and, as seen in this patient, paradoxical t h r o m b o e m b o l i s m. A d i s c u s s i o n o f morphologic forms, diagnostic imaging, clinical significance, and potential corrective procedures is reviewed. Case Report We present the case of a 64-year-old female who initially presented to care in the Bahamas for an acute middle cerebral artery stroke, thought to be thromboembolic in nature. TPA was administered, and she was transferred to Arizona for management and f u r t h e r w o r k u p. I n t h e s e a r c h ...
Advances in Clinical Medical Research and Healthcare Delivery, 2021
A persistent left superior vena cava (LSCV) is a form of anomalous venous drainage of the superior vena cava into the left atrium. We present a case of LSCV and partial anomalous pulmonary venous return (PAPVR) in a patient with progressively worsening dyspnea on exertion. A 57-year-old female with a history of aortic valve stenosis, and tobacco abuse presented with dyspnea on exertion for 4 days. On presentations her vitals were unremarkable except elevated blood pressure and oxygen saturation of 94% on 5L oxygen. Physical exam was pertinent for 3/6 crescendo-decrescendo murmur with a radiation to the right carotid, mild bibasilar crackles, and trace pitting edema in the lower extremity bilaterally. EKG showed normal sinus rhythm without ischemic changes. Echocardiogram showed preserved ejection fraction of 55% and moderately stenosed trileaflet aortic valve with a peak velocity 3.66 m/s and mean gradient 34 mmHg. A bubble study showed left atrium filling before right atrium raising suspicion for PLSVC or PAPVR with no intracardiac shunt. Further work up with heart catheterization as well as CT chest confirmed PLSVC with no coronary sinus dilation. Cardiac MRI (CMRI) showed PLSVC communicating with the coronary sinus with return into the right atrium and a small right-sided SVC (RSVC) draining into the superior right pulmonary vein with return into the left atrium. She remained asymptomatic with medical management for 2 years during regular cardiology follow up.
Heart, 1972
Various intracardiac defects may be associated with anomalous pulmonary venous drainage, atrial septal defect being the most common. However, reports of coexisting valvular heart disease are sparse. Two such cases are presented. In one patient the combination of anomalous venous connexion of the left pulmonary veins and atrial septal defect was associated with congenital aortic stenosis. The other patient had anomalous pulmonary venous connexion of the left lung and cal-S cific mitral regurgitation. Both patients presentedfor operation during their adult lives. Diagnostic procedures and operative treatment are discussed.
The Indian journal of radiology & imaging
Levoatrial cardinal vein (LACV) is anomalous connection between left atrium or pulmonary veins and systemic veins such as innominate vein or superior vena cava. This persistence of splanchnic circulation occurs when there is left-sided obstructive cardiac lesions such as hypoplastic left heart or mitral atresia. In this report we present three cases of LACV with well-developed left heart, without any obstructive lesions. All our cases presented with pulmonary arterial hypertension (PAH) and had associated intracardiac shunt such as ventricular/atrial septal defect and supracardiac partial anomalous pulmonary venous connection. Apart from the above shunts, LACV contributed to PAH in these cases. It is important to detect and report LACV as this may require surgical correction along with other defects. If LACV goes undetected during imaging workup, it may cause persistent PAH postoperatively.
Journal of the American Society of Echocardiography, 1997
Partial anomalous pulmonary venous connection, a rare congenital anomaly, most commonly involves the right lung, with one or more pulmonary veins anomalously connecting most frequently to the superior vena cava and less commonly to the right atrium or inferior vena cava. This article describes an unusual case of anomalous pulmonary venous connection of the right lung to the azygos vein in an adult. This anomaly was dearly delineated with angiography, computed tomography of the chest, and transesophageal echocardiography. The transesophageal echocardiographic features of the anomaly are described as a means to prevent further diagnostic misinterpretation. (J Am Soc Echocardiogr 1997;10:738-44.) Partial anomalous pulmonary venous connection (PAPVC), first described by Winslow in 1739, ~ is a rare congenital anomaly typified by persistence of an embryonic anastomosis between systemic veins and the pulmonary venous plexuses) -'~ The right lung is most commonly involved (80% to 90% of cases), with one or more pulmonary veins connecting most frequently to the superior vena cava and less commonly to the right atrium or inferior vena cava. 2,4,s Rarely, pulmonaly veins connect to the brachioccphalic veins, 4,6 portal vein, 7 azygos vein, s and coronary sinus. We present an unusual case of PAPVC of the right lung to the azygos vein in an adult. This anomaly was ininally missed on transesophageal echocardiography (TEE) but later was clearly delineated after angiographic diagnosis. This report highlights the TEE features of PAPVC as a means to prevent future diagnostic misinterpretation.
International Journal of Cardiology, 1994
This report briefly describes two cases of levoatriocardinal vein, in the setting of mitral atresia and a restrictive interatrial shunt, with clinical as well as echocardiographic features mimicking obstructive total anomalous pulmonary venous connection. One patient died of pulmonary hypertensive crisis, and the other survived the palliative procedures including the atrioseptectomy and pulmonary artery banding. The echocardiography, tine-angiocardiography, and magnetic resonance image for such an anomalous channel are presented. It is tempting to speculate that the thrombocytopenia and indirect hyperbilirubinemia be associated with the destructive consumption of thrombocytes and red blood cells in the serpentine levoatriocardinal vein.