Hostname: page-component-76fb5796d-vfjqv Total loading time: 0 Render date: 2024-04-25T09:06:28.624Z Has data issue: false hasContentIssue false
  • English
  • Français

Long-term outcome after percutaneous closure of persistent left superior caval vein draining into the left atrium: a contrast-enhanced CT study

Published online by Cambridge University Press:  08 May 2017

Davide Marini ,
Matteo Castagno ,
Michele Millesimo ,
Francesca Ferroni ,
Gaetana Ferraro ,
Carlo Pace Napoleone  and
Gabriella Agnoletti
Davide Marini*
Affiliation:
Division of Pediatric Cardiology, Ospedale Infantile Regina Margherita, Citta’ della Salute e della Scienza di Torino, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
Matteo Castagno
Affiliation:
Division of Pediatric Cardiology, Ospedale Infantile Regina Margherita, Citta’ della Salute e della Scienza di Torino, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
Michele Millesimo
Affiliation:
Division of Pediatric Cardiology, Ospedale Infantile Regina Margherita, Citta’ della Salute e della Scienza di Torino, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
Francesca Ferroni
Affiliation:
Division of Pediatric Cardiology, Ospedale Infantile Regina Margherita, Citta’ della Salute e della Scienza di Torino, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
Gaetana Ferraro
Affiliation:
Division of Pediatric Cardiology, Ospedale Infantile Regina Margherita, Citta’ della Salute e della Scienza di Torino, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
Carlo Pace Napoleone
Affiliation:
Division of Pediatric Cardiology, Ospedale Infantile Regina Margherita, Citta’ della Salute e della Scienza di Torino, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
Gabriella Agnoletti
Affiliation:
Division of Pediatric Cardiology, Ospedale Infantile Regina Margherita, Citta’ della Salute e della Scienza di Torino, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
*
Correspondence to: D. Marini, MD, PhD, Division of Pediatric Cardiology, Ospedale Infantile Regina Margherita, Città della Salute e della Scienza, University of Turin, Corso Spezia 60, 10126, Torino, Italy. Tel: +0039 011 313 1556; Fax: +0039 011 313 5482; E-mail: dmarini@cittadellasalute.to.it
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Data regarding long-term outcome after percutaneous closure of left superior caval vein draining into the left atrium are lacking. The aim of the present study was to report the long-term follow-up by using contrast-enhanced CT.

Methods

In all, three patients underwent percutaneous closure of left superior caval vein draining into the left atrium between 2005 and 2015. All of them were evaluated clinically and underwent contrast-enhanced CT.

Results

In one patient, the Amplatzer® Septal Occluder was used. In two patients, the Amplatzer® Vascular Plug type-1 was preferred: the device size/LSVC diameter ratio was 1.7 in the child and 1.2 in the adult. There were no early-onset or long-term onset complications. CT was performed 1, 2, and 10 years after the procedure, respectively. Complete occlusion of the vessel was documented in all. After 10 years since the procedure, CT revealed a persistent trivial residual shunt through the accessory hemiazygos vein in one patient, in whom the device was implanted above its drainage into the left superior caval vein. When an Amplatzer® Vascular Plug type-1 is oversized compared with the venous vessel diameter, it immediately assumes a dog-bone shape that disappears early to regain its shape memory and nominal size.

Conclusions

Percutaneous occlusion of left superior caval vein draining into the left atrium has excellent early and long-term outcomes. The optimal implantation of the device is below the drainage of the accessory hemiazygos vein, when present. The device might be oversized compared with the left superior caval vein diameter according to the age of the patient.

Keywords

CTleft superior caval veinembolisationcyanosis
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 8 , October 2017 , pp. 1550 - 1556
Check for updates
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Troost, E, Gewillig, M, Budts, W. Percutaneous closure of a persistent left superior vena cava connected to the left atrium. Int J Cardiol 2006; 106: 365–366.Google Scholar
2. Dehghani, P, Benson, LN, Horlick, EM. Transcatheter closure of persistent left sided superior vena cava draining into left atrium – importance of balloon test occlusion. J Invasive Cardiol 2009; 21: E122–E125.Google Scholar
3. Abadir, S, Bouzguenda, I, Boudjemline, Y, Agnoletti, G. Percutaneous occlusion of a left superior vena cava draining into the left atrium: two case reports. Arch Mal Coeur Vaiss 2007; 100: 470–473.Google ScholarPubMed
4. Kim, DH, Park, SJ, Jung, JW, Kim, NK, Choi, JY. Transcatheter treatment of patent foramen ovale combined with abnormal drainage of left superior vena cava to left upper pulmonary vein. J Cardiovasc Ultrasound 2013; 21: 33–36.Google Scholar
5. Filippini, LH, Ovaert, C, Nykanen, DG, Freedom, RM. Reopening of persistent left superior caval vein after bidirectional cavopulmonary connections. Heart 1998; 79: 509–512.CrossRefGoogle ScholarPubMed
6. Ou, P, Celermajer, DS, Calcagni, G, Brunelle, F, Bonnet, D, Sidi, D. Three-dimensional CT scanning: a new diagnostic modality in congenital heart disease. Heart 2007; 93: 908–913.CrossRefGoogle ScholarPubMed
7. Marini, D, Defilippi, C, Bordese, R, Agnoletti, G. Non invasive diagnosis of coronary obstruction in an infant with elastine-gene mutation by high-resolution multislice computed tomography. Int J Cardiol 2012; 157: e14–e15.CrossRefGoogle Scholar
8. Schoenhagen, P, Numburi, U, Halliburton, SS, et al. Three-dimensional imaging in the context of minimally invasive and transcatheter cardiovascular interventions using multi-detector computed tomography: from pre-operative planning to intra-operative guidance. Eur Heart J 2010; 31: 2727–2740.Google Scholar
9. Marini, D, Agnoletti, G, Pace Napoleone, C. Levoatriocardinal vein and partial anomalous pulmonary vein drainage in left-sided obstructive CHDs: diagnostic and surgical implications. Cardiol Young 2016; 26: 811–814.Google Scholar
10. Blackmon, JM, Franco, A. Normal variants of the accessory hemiazygos vein. Br J Radiol 2011; 84: 659–660.Google Scholar
11. Lacombe, P, Lacout, A, Marcy, PY, et al. Diagnosis and treatment of pulmonary arteriovenous malformations in hereditary hemorrhagic telangiectasia: an overview. Diagn Interv Imaging 2013; 94: 835–848.Google Scholar
12. Gupta, R, Pearson, A. Diagnosis of persistent left superior vena cava draining directly into the left atrium. N Am J Med Sci 2013; 5: 496–497.Google Scholar