Inferior Sinus Venosus Defects: Anatomic Features and Echocardiographic Correlates

详细信息    查看全文

• 作者：Jennifer Plymale (1) (4)
  Kellen Kolinski (1)
  Peter Frommelt (1)
  Peter Bartz (1) (2)
  James Tweddell (3)
  Michael G. Earing (1) (2)
  
• 关键词：Inferior extension ; Inferior sinus venosus defect ; Secundum atrial septal defect
• 刊名：Pediatric Cardiology
• 出版年：2013
• 出版时间：February 2013
• 年：2013
• 卷：34
• 期：2
• 页码：322-326
• 全文大小：215KB
• 参考文献：1. Al Zaghal AM, Li J, Anderson RH, Lincoln C, Shore D, Rigby ML (1997) Anatomical criteria for the diagnosis of sinus venosus defects. Heart 78:298-04
  2. Banka P et al (2011) Outcomes of inferior sinus venosus defect repair. J Thorac Cardiovasc Surg 142:517-22 CrossRef
  3. Crystal MA et al (2009) Inferior sinus venosus defect: echocardiographic diagnosis and surgical approach. J Thorac Cardiovasc Surg 137:1349-355 CrossRef
  4. Ettedgui JA et al (1990) Diagnostic echocardiographic features of the sinus venosus defect. Br Heart J 64:329-31 CrossRef
  5. Ettedgui JA et al (1992) Echocardiographic diagnosis of inferior sinus venosus defects. Cardiol Young 2:338-41 CrossRef
  6. Geddes AC (1912) Abnormal superior vena cava. Anat Anz 41:449-53
  7. Gustafson RA et al (1989) Partial anomalous pulmonary venous connection to the right side of the heart. J Thorac Cardiovasc Surg 98(5 Pt 2):861-68
  8. Ingalls N (1907) Report: communication between the right pulmonary veins and the superior vena cava. Anat Rec 1:14
  9. Kronzon I, Tunick PA, Freedberg RS, Trehan N, Rosenzweig BP, Schwinger ME (1991) Transesophageal echocardiography is superior to transthoracic echocardiography in the diagnosis of sinus venosus atrial septal defect. J Am Coll Cardiol 17:537-42
  10. Ross DN (1956) The sinus venosus type of atrial septal defect. Guys Hosp Rep 105:376-81
  11. Shaner R (1958) The high defect in the atrial septum. Can Med Assoc J 78:688-89
  12. Van Cleave C (1931) A multiple anomaly of the great veins and interatrial septum in a human heart. Anat Rec 50:45-1 CrossRef
  13. Van Praagh S, Carrera ME, Sanders SP, Mayer JE, Van Praagh R (1994) Sinus venosus defects: unroofing of the right pulmonary veins: anatomic and echocardiographic findings and surgical treatment. Am Heart J 128:365-79
  
• 作者单位：Jennifer Plymale (1) (4)
  Kellen Kolinski (1)
  Peter Frommelt (1)
  Peter Bartz (1) (2)
  James Tweddell (3)
  Michael G. Earing (1) (2)
  
  1. Department of Pediatrics, Division of Cardiology, Medical College of Wisconsin, Milwaukee, WI, USA
  4. Children’s Hospital of Wisconsin, 9000?W Wisconsin Avenue, Milwaukee, WI, 53226, USA
  2. Department of Internal Medicine, Division of Adult Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
  3. Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
  
• ISSN：1432-1971

文摘

Inferior sinus venosus defects (SVDs) are rare imperfections located in the inferior portion of the atrial septum, leading to an overriding inferior vena cava (IVC) and an interatrial connection. These defects have increased risk of anomalous pulmonary venous return (PAPVR) and often are confused with secundum atrial septal defects (ASDs) with inferior extension. The authors sought to review their experience with inferior SVDs and to establish at their institution an echocardiographic definition that differentiates inferior SVDs from secundum ASDs with inferior extension. The study identified 161 patients 1.5 to 32?years of age who had undergone repair of a secundum ASD with inferior extension or inferior SVD over the preceding 10?years. All surgical notes, preoperative transthoracic echocardiograms (TTEs), and preoperative transesophageal echocardiograms (TEEs) were reviewed. Based on the surgical notes, 147 patients were classified as having a secundum ASD (147/161, 91?%) and 14 patients (9?%) as having an inferior SVD. The study identified PAPVR in 7?% (1/14) of the patients with inferior SVDs and 3.5?% (5/14) of the patients with secundum ASDs. Surgical diagnosis and preoperative TTE correlated for 143 (89?%) of the 161 patients. Using a strict anatomic and echocardiographic definition with a blinded observer, the majority of the defects (14/18, 78?%) were reclassified correctly after review of their TTE images, and 100?% of the defects were correctly reclassified after TEE image review. Accurate diagnosis of inferior SVDs remains challenging. The data from this study demonstrate that use of a strict anatomic and echocardiographic definition (a defect that originates in the mouth of the IVC and continues into the inferoposterior border of the left atrium, leaving no residual atrial septal tissue at the inferior margin) allows for accurate differentiation between secundum ASDs with inferior extension and inferior SVDs. This differentiation is extremely important in planning for surgical versus device closure of these rare defects.