Document Type : Case Report
Authors
- Zahra Khajali 1
- Fateme Jorfi 2
- Mohamad Sadra Nazari 3
- Maryam Keshavarz-Hedayati 4
- Maziar Gholampour-Dehaki 5
1 Associate Professor, Rajaei Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
2 Assistant Professor, Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
3 Assistant Professor, Department of Vascular Surgery, Qazvin University of Medical Sciences, Qazvin, Iran
4 Atherosclerosis Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
5 Professor, Heart Valve Disease Research Center, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Abstract
BACKGROUND: Atrial septal defects (ASDs) are one of the most common congenital cardiac abnormalities. Repair of these defects is a quite secure and routine operation. The most common complications were postoperative atrial arrhythmias, sinus arrhythmia, and atrioventricular (AV) blocks requiring pacemaker implantation, mediastinal bleeding, and transient ischemic attacks (TIAs) or strokes. Iatrogenic diversion of the inferior vena cava (IVC) to the left atrium (LA) during surgical closure of an ASD is a very rare complication.
CASE REPORT: We reported a patient who had a history of cardiac surgery in another center at the age of seven and was introduced to our clinic with complaints of dyspnea and cyanosis of extremities on exertion. She underwent surgery in our center with diagnosis of iatrogenic diversion of IVC to LA.
CONCLUSION: The most common mechanism suggested is a large eustachian valve being mistaken for the inferior rim of the ASD.
Keywords
- Thompson E, Moritz D, Perdue R, Cansino S. Diversion of the inferior vena cava following repair of atrial septal defect causing hypoxemia. Echocardiography 2004; 21(4): 329-32.
- Tayeh C, El KM, Bitar F, Arabi M. Atrial septal defect closure complicated by anomalous inferior vena cava return to the left atrium: A case report of a 5-year-old child. Eur Heart J Case Rep 2019; 3(2).
- Desai M, Talwar S, Kothari SS, Jagia P, Airan B. Inferior vena cava to left atrium shunt presenting with polycythemia and stroke three decades following closure of atrial septal defect. Congenit Heart Dis 2013; 8(4): E102-E105.
- Desnick SJ, Neal WA, Nicoloff DM, Moller JH. Residual right-to-left shunt following repair of atrial septal defect. Ann Thorac Surg 1976; 21(4): 291-5.
- Zhang Y, Song H, Qiao X, Xiao X, Liu J, Wang X. Detection and diagnosis of iatrogenic inadvertent diversion of partial inferior vena cava into the left atrium by transesophageal echocardiography during large posteroinferior surgical atrial septal defect closure. J Anesth 2015; 29(3): 442-5.
- Jain SA, Pinto R, Dalvi B. Iatrogenic diversion of IVC to left atrium after surgical closure of ASD. Ann Pediatr Cardiol 2012; 5(1): 72-4.