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01-06-2015 | Clinical Report

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

Authors: Yanzi Zhang, Haibo Song, Xin Qiao, Xijun Xiao, Jin Liu, Xiao Wang

Published in: Journal of Anesthesia | Issue 3/2015

Abstract

Iatrogenic diversion of the inferior vena cava (IVC) into the left atrium (LA) is usually reported as a rare complication following large posteroinferior atrial septal defect (ASD) surgery. It may cause acute or chronic hypoxemia, and other potentially life-threatening complications such as stroke. We present a case in which the ASD patch straddled the IVC entrance diagnosed immediately by transesophageal echocardiography (TEE) during the period of patient separated from cardiopulmonary bypass, avoiding the related complications. Our report further underlines the important role of TEE to monitor and guide ASD surgical management, especially secundum ASD with inferior extension or inferior sinus venosus defects, for the early diagnosis of iatrogenic surgical errors.

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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;8:102–5.CrossRef

Thompson E, Moritz D, Perdue R, Cansino S. Diversion of the inferior vena cava following repair of atrial septal defect causing hypoxemia. Echocardiography. 2004;21:329–32.CrossRefPubMed

Unger P, Bondue A, Loiseau J, Dessy H, Primo G, Le Clerc JL. Right-to-left shunting with normal pulmonary pressure complicating atrial septal defect surgery. Int J Cardiol. 2006;113:252–3.CrossRefPubMed

Beitzke D, Koestenberger M, Knez I, Beitzke A. Anomalous connection of the inferior vena cava to the left atrium: a surgical error in closing an atrial septal defect. Clin Res Cardiol. 2008;97:191–3.CrossRefPubMed

Jain SA, Pinto R, Dalvi B. Iatrogenic diversion of IVC to left atrium after surgical closure of ASD. Ann Pediatr Cardiol. 2012;5:72–4.CrossRefPubMedPubMedCentral

Bjork VO, Johansson L, Jonsson B, Norlander O, Nordenstrom B. The operation and management of a case after diversion of the inferior vena cava into the left atrium after the open repair of an atrial septal defect. Thorax. 1958;13:261–6.CrossRefPubMedPubMedCentral

Plymale J, Kolinski K, Frommelt P, Bartz P, Tweddell J, Earing MG. Inferior sinus venosus defects: anatomic features and echocardiographic correlates. Pediatr Cardiol. 2013;34:322–6.CrossRefPubMed

Ross JK, Johnson DC. Complications following closure of atrial septal defects of the inferior vena caval type. Thorax. 1972;27:754–8.CrossRefPubMedPubMedCentral

Title: 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
Authors: Yanzi Zhang
Haibo Song
Xin Qiao
Xijun Xiao
Jin Liu
Xiao Wang
Publication date: 01-06-2015
Publisher: Springer Japan
Published in: Journal of Anesthesia / Issue 3/2015
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI: https://doi.org/10.1007/s00540-014-1925-4

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Springer Medicine

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

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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