Abnormal drainage of inferior vena cava to left atrium combined with atrial septal defect: A case report. (July 2022)

• Record Type: Journal Article
• Authors: Wang, Xingming; Zhou, Mei; Wang, Lei; Han, Lei; Li, Peng; Nie, Fei; Li, Zeshu
• Is Part Of: International journal of surgery case reports. Volume 96(2022)
• Publication Date: 2022-07
• Subjects: Vena cava -- Inferior -- Atrial septal defect 6 [supplementary concept] -- Image enhancement -- Ultrasonography; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2022.107384
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Systemic venous anomaly is less common clinically, and ectopic connection of inferior vena cava is less common clinically than ectopic connection of superior vena cava. When the inferior vena cava is abnormally connected to the left atrium, a low atrial septal defect can be combined. It is difficult to make preoperative diagnosis of this kind of disease clinically. Blind occlusion of the ASD (atrial septal defect) will cause the iatrogenic inferior vena cava flowing back to the left atrium completely or partially. Conventional median thoracotomy for repair of such an atrial septal defect should be performed with more caution. It has been reported that after repair of an atrial septal defect, the inferior vena cava was mistakenly separated into the left atrium. Therefore, we suggest that preoperative evaluation of inferior atrial septal defect should be with more cautious. When transthoracic echocardiography (TTE) cannot fully explain the clinical symptoms, Ultrasound contrast may be considered. During the repair of the inferior vena cava ASD, it is not only necessary to find the location of Euclidean valve, but also to accurately explore the inferior vena cava opening so as to avoid the iatrogenic inferior vena cava being separated into the left atrium. Highlights: This case is a rare clinical case of inferior vena cava connecting to the left atrium. Preoperative ultrasonography was misdiagnosed as simple atrial septal defect. After the failure of attempted closure, decidedly minimally invasive surgery was necessary.