[HSF] ask Pasanna

[Prasanna Simha M]

One more quick shot

*Partial anomalous pulmonary venous return*

In PAPVR, not all pulmonary veins drain abnormally. One or more pulmonary
veins abnormally return to the superior or inferior vena cava, the right
atrium, or the coronary sinus.
Ultimately itwas a PAPVC to CS. Did you draw samples from RA RV and PA ? to
determine the shunt. If it was insignificant you could just leave it
alone.(Especially if itwas just one vein). I would be curious to see the
chest X Ray of this patient.
What did you do ultimately ?
Prasanna

On 1/3/07, Prasanna Simha M <prasannasimha at gmail.com> wrote:
>
> I am in th hospital and so a quick response - will look in detail later.
> * * Jpn J Thorac Cardiovasc Surg. 1998 Nov;46(11):1211-4. Related
> Articles,
> <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=pubmed_Abstract&db=pubmed&cmd=Display&dopt=pubmed_pubmed&from_uid=9884580&itool=ExternalSearch>
> Links
> *[Surgical repair of coronary sinus type partial anomalous pulmonary
> venous drainage with intact atrial septum]*
>
> [Article in Japanese]
>
> *Aoki A*<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Aoki+A%22%5BAuthor%5D>,
> *Kubota T*<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Kubota+T%22%5BAuthor%5D>,
> *Nakai M*<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Nakai+M%22%5BAuthor%5D>,
> *Inoue M*<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Inoue+M%22%5BAuthor%5D>,
> *Sano S*<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Sano+S%22%5BAuthor%5D>
> .
>
> Department of Cardiovascular Surgery, Okayama University Medical School,
> Japan.
>
> We experienced a rare form of PAPVD without atrial septal defect. The
> patient was a 33-year-old male and he was referred to our institute because
> of mild right pulmonary congestion detected by a routine chest X-P. Enlarged
> coronary sinus, right atrium and right ventricle were documented by UCG. The
> Qp/Qs was 1.9 and pulmonary artery pressure was 38/7 mmHg (mean: 17 mmHg)
> by cardiac catheterization. Selective pulmonary angiogram showed that all
> right pulmonary veins drained into the coronary sinus without evidence of an
> atrial septal defect. Enhanced chest CT clearly demonstrated the connection
> between the right pulmonary vein and the coronary sinus. Intracardiac repair
> without atrial baffle was carried out under hypothermic cardiopulmonary
> bypass. Under cardiac arrest with cardioplegia, the common wall between the
> right pulmonary vein and the left atrium was incised and the connection
> between the right pulmonary vein and the left atrium was established. The
> flap made by this incision was brought posterior to close the right
> pulmonary vein opening to the coronary sinus. The postoperative course was
> uneventful and the minimum diameter of the right pulmonary vein was found to
> be 15.5 mm by a postoperative pulmonary artery angiogram. This operative
> method without an atrial baffle could be an alternative procedure for
> coronary sinus type PAPVD.
>
> Publication Types:
>
>    - Case Reports
>    - English Abstract
>
>
> PMID: 9884580 [PubMed - indexed for MEDLINE]
>
> On 1/3/07, Donald Ross <donross at bigpond.com> wrote:
> >
> > I came across a congenital abnormality I had not previously
> > encountered today.
> > While upending the heart for a pda graft I noticed what looked like a
> > pericardial adhesion a 4 cm left of the IVC. I hoed into it with the
> > scissors but could not find a plane so started dissecting and found a
> > 0.5cm vein connecting the coronary sinus to presumably the L lower lobe.
> > I guess it was an aberrant pulmonary vein?
> > Don
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>
>
> --
> Prasanna Simha M




-- 
Prasanna Simha M