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Published on: October 28, 2020
Veno-venous bridges: the forerunners of the sinus venosus defect
Ryan J Butts1, Andrew M Crean, Anthony M Hlavacek
1Department of Pediatric Cardiology, Medical University of South Carolina, Charleston, USA. butts@musc.edu
Insights
Sinus venosus defects are not true septal defects but result from persistent fetal venous connections. This finding clarifies the developmental origin of these cardiac anomalies.
Area of Science:
- Cardiology
- Developmental Biology
- Medical Imaging
Background:
- Distinguishing sinus venosus defects from other atrial septal defects is challenging.
- Existing theories on sinus venosus defects lack comprehensive explanation.
- Persistent systemic to pulmonary venous connections are hypothesized causes.
Observation:
- Reviewed clinical histories and radiological findings of six patients.
- Identified veno-venous bridges in three patients.
- Observed partial anomalous pulmonary venous connections in two patients and a sinus venosus defect in one.
Findings:
- Radiographic, developmental, and morphological evidence supports a new theory.
- Sinus venosus defects arise from persistent fetal systemic to pulmonary veno-venous bridges.
- This contrasts with the traditional view of atrial septal deficiencies.
Implications:
- Revises understanding of congenital heart anomalies.
- Provides a basis for improved diagnostic criteria.
- Offers insights into the embryological development of cardiac structures.
Background:
Differentiation of the so-called sinus venosus defect from other defects permitting shunting between the atrial chambers remains problematic. The lesion is not a true septal defect, and current theories to explain the existence of the sinus venosus defect fall short. The presence of persistent systemic to pulmonary venous connections has been proposed to explain the existence of the sinus venosus defect.
Methods:
Clinical histories and radiological findings of six patients are reviewed. Three patients have veno-venous bridges, two have partial anomalous pulmonary venous connections, and one patient has a sinus venosus defect. The clinical information is reviewed, along with current developmental and morphological considerations.
Discussion:
We provide radiographic, developmental, and morphological evidence to support the theory that a so-called sinus venosus defect is the consequence of persistence of foetal systemic to pulmonary veno-venous bridges, rather than of deficiencies in atrial septation.
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