Extracardiac rerouting of the persistent left superior vena cava in the left isomerism heart
Noriyasu Kawada1, Masaaki Yamagishi, Kiyozo Morita
1Department of Cardiovascular Surgery, Saitama Children's Hospital, Saitama, Japan.
Insights
This study details a successful extracardiac rerouting surgery for a child with isomerism heart and persistent left superior vena cava. The procedure allowed the patient to recover fully and live a normal life.
Area of Science:
- Congenital heart disease
- Pediatric cardiac surgery
- Cardiovascular anatomy
Background:
- Isomerism heart presents complex systemic and pulmonary venous connections requiring surgical solutions.
- Persistent left superior vena cava (PLSVC) is a common anomaly in patients with isomerism.
- Previous intraatrial rerouting techniques pose risks of venous drainage obstruction.
Observation:
- A 6-year-old girl with isomerism heart, bilateral superior vena cava, partial anomalous pulmonary venous connection, and atrioventricular septal defect was treated.
- Intraatrial rerouting of the PLSVC was deemed technically unfeasible due to potential venous obstruction.
- Extracardiac rerouting was chosen as the surgical approach.
Findings:
- Successful extracardiac rerouting of the persistent left superior vena cava was performed.
- The patient experienced an uneventful recovery following the surgery.
- The patient has remained well with normal function 6 years post-operation.
Implications:
- Extracardiac rerouting is a viable and effective surgical option for PLSVC in complex isomerism heart cases.
- This technique avoids the risks associated with intraatrial rerouting, ensuring adequate venous drainage.
- The long-term success demonstrates the potential for excellent outcomes and normal life quality in affected children.
Abstract:
The left isomerism heart is common to have various forms of the systemic and pulmonary venous connections, for which numerous reparative methods have been proposed. This report describes a successful extracardiac rerouting of the persistent left superior vena cava of a 6-year-old girl patient having the isomerism heart, bilateral superior vena cava, partial anomalous pulmonary venous connection, and partial form of the atrioventricular septal defect. Intraatrial rerouting of the left superior vena cava was found unfeasible, since this procedure had a potential hazard to obstruct the systemic and/or pulmonary venous drainage. The patient recovered uneventfully and is leading a normal life 6 years after the surgery.
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