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Two cases of scimitar variant

S Takeda1, T Imachi, K Arimitsu

  • 1Department of Cardiovascular Surgery, Ehime National Hospital, Japan.

Chest
|January 1, 1994
PubMed
Summary
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The scimitar sign, typically indicating anomalous pulmonary venous drainage, presented with two unique variations. These cases highlight the importance of detailed imaging for diagnosing and managing this rare congenital heart condition.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Congenital Heart Disease

Background:

  • The scimitar sign is a radiological finding associated with partial anomalous pulmonary venous drainage into the inferior vena cava (IVC).
  • This sign typically involves a characteristic curvilinear shadow on chest imaging.
  • Understanding its variations is crucial for accurate diagnosis and treatment planning.

Observation:

  • Two variant presentations of the scimitar sign were observed.
  • Case 1: A scimitar vein drained into both the IVC and the left atrium (LA) without intracardiac shunts.
  • Case 2: A scimitar vein exhibited a meandering course and drained directly into the LA, bypassing the IVC.

Findings:

  • Retrograde balloon occlusion angiography proved diagnostic in identifying the anomalous venous connection.

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  • Surgical repair, including simple ligation of the scimitar vein, was successfully performed in the first case to correct a left-to-right shunt.
  • The second case did not require surgical intervention due to the specific drainage pattern.
  • Implications:

    • These variants expand the spectrum of the scimitar sign and its associated venous drainage patterns.
    • Accurate radiological diagnosis is essential for determining appropriate management strategies, surgical or conservative.
    • Further research into these rare presentations can improve understanding of congenital heart anomalies.