Total anomalous systemic venous drainage

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Ramachandra Barik

http://www.annalspc.com/article.asp?issn=0974-2069;year=2014;volume=7;issue=2;spage=98;epage=102;aulast=Awasthy

Salud y medicina Tecnología

Total anomalous systemic
venous drainage to the left
atrium
A Sharp eye on left atrial isomerism is must

Introduction

Classification TASVD
Type I Type II Type III
IVC to left-sided atrium IVC interruption IVC to accessory chamber (like
coronary sinus)
 Type A: Hepatic veins to left-
sided atrium
 Type B: Hepatic veins to
other site

Zhang ZW, Duan QJ, Gao Z, Ru W, Ying LY. Total anomalous
systemic venous drainage to the left atrium. Ann Thorac Surg
2009;87:1599-601-13

Embryology
• Failure of regression of the right valve of systemic venous sinus (sinus
venosus)
• Systemic venous sinus being incorporated into the left atrium

Hemodynamic
• Left atrium forms the mixing chamber in the circuit
• Similar to the case of a total anomalous pulmonary venous drainage
• Oxygen saturation is equal in all the chambers

Diagnosis
• Echocardiography with agitated saline contrast follow up(caution :air
embolism to brain and coronary)
• CT scan helps confirm drainage of all veins

Treatment
• Surgery

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Total anomalous systemic venous drainage

1. Total anomalous systemic venous drainage to the left atrium A Sharp eye on left atrial isomerism is must

2. Introduction

3. Classification TASVD Type I Type II Type III IVC to left-sided atrium IVC interruption IVC to accessory chamber (like coronary sinus)  Type A: Hepatic veins to left- sided atrium  Type B: Hepatic veins to other site

4. Zhang ZW, Duan QJ, Gao Z, Ru W, Ying LY. Total anomalous systemic venous drainage to the left atrium. Ann Thorac Surg 2009;87:1599-601-13

5. Embryology • Failure of regression of the right valve of systemic venous sinus (sinus venosus) • Systemic venous sinus being incorporated into the left atrium

6. Hemodynamic • Left atrium forms the mixing chamber in the circuit • Similar to the case of a total anomalous pulmonary venous drainage • Oxygen saturation is equal in all the chambers

7. Diagnosis • Echocardiography with agitated saline contrast follow up(caution :air embolism to brain and coronary) • CT scan helps confirm drainage of all veins

8. Treatment • Surgery

9. Think before you choose