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Published on: June 16, 2023
A rare pathology: Levoatriocardinal vein
Öykü Tosun1, Murat Saygı2, Taner Kasar2
1Department of Pediatric Cardiology, Mehmet Akif Ersoy Cardiovascular Training and Research Hospital, İstanbul, Turkey. isaltosun@hotmail.com.
Insights
Levoatriocardinal vein (LACV) is a rare cardiac anomaly, often linked to left-sided obstructive lesions. This study reviews 11 cases, highlighting diagnostic echocardiographic views and clinical presentations.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Levoatriocardinal vein (LACV) is a rare congenital anomaly connecting the pulmonary venous and cardinal systems.
- It is infrequently encountered and often associated with other cardiac defects.
Purpose of the Study:
- To describe the morphological and clinical characteristics of LACV.
- To outline diagnostic methods for identifying LACV.
- To review institutional experience with LACV cases.
Main Methods:
- Retrospective review of 11 patients diagnosed with LACV between 2010 and 2014.
- Echocardiography was the primary diagnostic tool to confirm LACV presence and assess associated lesions.
- Evaluation included identification of left-sided obstruction and interatrial septum integrity.
Main Results:
- 82% of patients were diagnosed under one year of age.
- Nine patients presented with left-sided obstruction; two had normal intracardiac anatomy.
- Echocardiography in specific views confirmed LACV originating from the left atrium in all cases.
Conclusions:
- LACV is extremely rare and predominantly occurs with left-sided obstructive lesions.
- Consideration of LACV is crucial in patients with left-sided obstructions.
- LACV can also manifest in individuals with normal intracardiac anatomy and pulmonary venous return.
Objective:
Levoatriocardinal vein (LACV) is a rare cardiac pathology that represents a connection between the pulmonary venous and cardinal systems. The aim of the present study was to discuss morphological and clinical characteristics, as well as diagnostic methods, of experience with LACV.
Methods:
Records of 11 patients (4 male, 7 female; mean age 79±1.83 days; range 1-390 days) diagnosed with LACV between 2010 and 2014 were retrospectively reviewed. Presence of LACV was confirmed with echocardiography. The primary obstructive lesion associated with cardiac defects and the integrity of the interatrial septum was identified in each patient with left-sided obstruction.
Results:
Mean weight was 4.4±0.4 kg (range: 2-8). Age at presentation was under 1 year in 82% of patients. Nine patients had left-sided obstruction, and 2 had normal intracardiac anatomy and pulmonary venous return. In patients with left-sided obstruction, LACV was initially demonstrated with echocardiographic evaluation, performed in apical 4-chamber, high parasternal, and subcostal views. Atrial septum was restrictive or intact in patients with left-sided obstructions. LACV originated directly from the left atrium in all patients.
Conclusion:
Levoatriocardinal vein is an extremely rare cardiac pathology, presenting almost exclusively in patients with left-sided obstructive lesions. In patients with left-sided obstructions, LACV must be kept in mind. It may also present in patients with normal intracardiac anatomy and pulmonary venous return.
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