Multiple thromboembolic events associated with bilateral superior vena cava and anomalous drainage into the left atrium

A 49-year-old female patient presented with acute-on-chronic chest pain. She was diagnosed with multiple systemic thromboemboli, including myocardial infarctions, bilateral chronic pulmonary emboli, ischaemic stroke, deep venous thrombosis and superficial thrombophlebitis. She had a background of sickle cell trait. Cardiac magnetic resonance showed bilateral superior vena cava (SVC). The right-sided SVC (RSVC) was joined by the right upper pulmonary vein and drained anomalously into the left atrium. This caused a small volume right to left shunt. The persistent left SVC drained into the right atrium (RA) via a dilated coronary sinus. The overall clinical impression was recurrent paradoxical emboli due to anomalous venous anatomy with a thrombophilia secondary to sickle cell trait. In the normal embryo, the right common cardinal vein develops to become the RSVC, which drains into the RA by term.

Percutaneous atrial septal defect closure in infant weighing <10 kg and having a bilateral superior vena cava: a case report

Percutaneous closure has become a preferred treatment for secundum atrial septal defect (ASD). However, this approach remains challenging in treating small infant weighing <10 kg because of procedure-related complications. The closure of ASD in other congenital anomalies, such as a bilateral superior vena cava (SVC), should be cautiously conducted. A 15-month-old boy with a body weight of 8 kg was diagnosed with secundum ASD (9–11 mm in diameter), residual pulmonary stenosis, and bilateral SVC. Transcatheter closure of ASD was successfully performed by using a 12 mm CeraFlex occluder device (Lifetech Scientific Corporation). Post-procedural examination showed good results without any impingement to the adjacent structure. Therefore,the transcatheter closure of ASD in infant weighing <10 kg and having bilateral SVC is technically feasible and safe.

Manajemen Anestesi Prosedur Fontan

PendahuluanSingle ventricle merupakan kelainan jantung kongenital kompleks, dan seseorang yang hidup dengan kelainan ini akan disertai dengan sejumlah keterbatasan. Tanpa terapi bedah, univentrikel akan menjadi malapetaka. Prosedur Fontan merupakan teknik pembedahan terpilih yang dapat diterapkan pada pasien dengan single ventricle. Hasil prosedur Fontan dipengaruhi oleh beberapa faktor termasuk faktor, prosedur, pengelolaan, dan tekanan vena sisi kanan berangsur-angsur akan meningkat. Seiring dengan berjalannya waktu gagal jantung kanan akan mengalami penurunan fungsi sistem, meliputi peningkatan resistensi pembuluh darah pulmoner (PVR), peningkatan tekanan vena sistemik (SVR), low-cardiac output kronis, disfungsi ventrikel kanan, dan kegagalan prosedur perbaikan single ventricle. Presentasi KasusWanita 19 tahun dengan Double Outlet Right Ventricle, Ventricular Septal Defect, Pulmonal Stenosis, Patent Ductus Arteriosus, Bilateral Superior Vena Cava yang akan menjalani prosedur Fontan. KesimpulanProsedur Fontan akan meningkatkan usia harapan hidup pasien. Keberhasilan jangka panjang ditentukan oleh banyaknya komplikasi. Dalam kondisi tidak adanya ketaatan.