Journal of Cardiothoracic Surgery | |
Missed case of sinus venosus atrial septal defect post coronary artery bypass grafting | |
Sriram Shankar1  Winn Maung Maung Aye1  Sudeep Das De1  | |
[1] National University Health System, 1E Kent Ridge Road, Kent Ridge 119228, Singapore | |
关键词: CABG; Partial anomalous pulmonary venous drainage; Sinus venosus atrial septal defect; | |
Others : 804745 DOI : 10.1186/1749-8090-9-91 |
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received in 2013-11-30, accepted in 2014-05-06, 发布年份 2014 | |
【 摘 要 】
We report a case of a 41-year-old Indian man who initially underwent an emergency coronary artery bypass grafting surgery (CABG) after presenting with an anterolateral myocardial infarction.
Post-operatively he developed progressively worsening symptoms of right heart failure with increasing abdominal distension and lower limb swelling. Clinically, the patient was in NYHA class 4 heart failure.
He was admitted multiple times for the treatment of his heart failure, which was recalcitrant to diuretic therapy.
He subsequently underwent an MRI scan, which revealed near transmural myocardial infarction involving mainly the left side of the heart. The right atrium and ventricle were grossly dilated, with moderate to severe right ventricular systolic dysfunction. A sinus venosus atrial septal defect with right-sided partial anomalous pulmonary venous drainange (PAPVD) was noted. He subsequently underwent surgery to repair the sinus venosus atrial septal defect (ASD) as well as re-route the PAPVD to the left atrium (LA). He was discharged on post-operative day 19 with oral diuretics.
On follow-up at 1 month, the patient's symptoms had resolved and his clinical status corresponded to NYHA class 1–2.
【 授权许可】
2014 De et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20140708064857319.pdf | 1026KB | download | |
Figure 1. | 35KB | Image | download |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Webb G, Gatzoulis MA: Atrial septal defects in the adult: recent progress and overview. Circulation 2006 October 10, 114(15):1645-53.
- [2]Shimoyama Y, Sawai T, Nakahira J, Minami T: [Atrial septal defect of sinus venous type diagnosed by transesophageal echocardiography intraoperatively]. Masui 2009, 58(2):189-192.
- [3]Fores B, Olmos M, de SA O, Gonzalez JA: [Incidental diagnosis of an ostium-secundum-type interatrial communication during coronary surgery]. Rev Esp Anestesiol Reanim 2003, 50(6):299-302.
- [4]Taylor AM, Stables RH, Poole-Wilson PA, Pennell DJ: Definitive clinical assessment of atrial septal defect by magnetic resonance imaging. J Cardiovasc Magn Reson 1999, 1(1):43-7.
- [5]Prompona M, Muehling O, Naebauer M, Schoenberg SO, Reiser M, Huber A: MRI for detection of anomalous pulmonary venous drainage in patients with sinus venosus atrial septal defects. Int J Cardiovasc Imaging 2011 March, 27(3):403-12.