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Persistent left superior vena cava in cardiac congenital surgery
Cristina Giuliani-Poncini1, Marie-Hélène Perez, Jacques Cotting
1Pediatric Intensive Care Unit, University Hospital Center and University of Lausanne, Lausanne, Switzerland.
Pediatric Cardiology
|July 4, 2013
Summary
Persistent left superior vena cava (LSVC) in children with congenital heart disease increases mortality risk after cardiac surgery. Early diagnosis and recognition of associated anomalies are crucial for better outcomes.
Area of Science:
- Cardiology
- Pediatric Surgery
- Medical Imaging
Background:
- Persistent left superior vena cava (LSVC) is a common finding in congenital cardiac malformations.
- Understanding its impact on surgical outcomes is vital for pediatric cardiac patients.
Purpose of the Study:
- To analyze the diagnostic timing of persistent LSVC and associated coronary sinus anomalies.
- To evaluate the impact of persistent LSVC on morbidity and mortality in children undergoing cardiac surgery.
Main Methods:
- Retrospective analysis of 371 children with congenital heart disease undergoing cardiac surgery on bypass.
- Echocardiography was used for pre-operative diagnosis of persistent LSVC.
Main Results:
- Persistent LSVC was present in 12.7% of patients, with 83% diagnosed pre-operatively.
- Complications included left ventricular inflow obstruction (6.4%) and coronary sinus anomalies (17%).
- Mortality was significantly higher in patients with persistent LSVC (10.6% vs. 2.5%).
Conclusions:
- Persistent LSVC in congenital heart disease is associated with increased mortality after cardiopulmonary bypass.
- Pre-operative recognition of persistent LSVC and its anomalies is essential to prevent surgical complications.
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