Left superior vena cava to the left atrium: do we have to change the traditional approach?
S Zimand1, P Benjamin, M Frand
1Cardiac Institute Department of Pediatric Cardiology, Sackler School of Medicine, Chaim Sheba Medical Center, Tel Hashomer, Israel. zimandsh@netvision.net.il
Insights
Congenital left superior vena cava (LSVC) to the left atrium anomalies can be effectively treated with simpler surgical methods. Acute ligation or extracardiac repair offers a less invasive alternative to traditional intraatrial baffle techniques.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Thoracic Surgery
Background:
- Left superior vena cava (LSVC) to the left atrium is a rare congenital cardiac anomaly.
- It can occur as an isolated defect or with complex cardiac anomalies.
- Traditional surgical repair involves an intraatrial baffle technique.
Observation:
- This study presents three pediatric patients with LSVC to the left atrium.
- All patients underwent acute ligation and extracardiac repair.
- Short-term, transient congestion in the upper body was observed post-surgery.
Findings:
- Acute ligation and extracardiac repair are simpler and easier surgical solutions for LSVC to the left atrium.
- These methods require less myocardial ischemic time compared to intraatrial baffle repair.
- The observed congestion resolved completely within weeks without complications.
Implications:
- Acute ligation and extracardiac repair represent effective and less invasive treatment options for LSVC to the left atrium.
- These techniques simplify surgical management and reduce patient morbidity.
- Further research into extracardiac options can optimize outcomes for this rare anomaly.
Abstract:
Left superior vena cava (LSVC) to the left atrium is a rare congenital cardiac complex, which may appear as an isolated anomaly, or as part of more complex cardiac anomalies. Traditionally, an intraatrial baffle was the preferred surgical technique. Although this technique has proved reliable and successful, acute ligation and extracardiac repair are simpler and easier solutions, requiring less myocardial ischemic time. We present 3 patients who underwent simple ligation and discuss the literature for other extracardiac options of surgical repair. Our patients had short transient congestion in the left upper part of their body that resolved completely after a few weeks, without further complications. We believe that either acute ligation or extracardiac repair is a much simpler yet effective solution to divert the left caval flow to the lesser circulation.
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