Perioperative management of a levoatrial cardinal vein in the absence of the brachiocephalic vein

Tex Heart Inst J. 2013;40(2):201-3.

Abstract

Levoatrial cardinal vein is a rare congenital anomaly of the systemic veins. It is commonly associated with left-sided obstructive conditions such as aortic atresia, mitral atresia, and cor triatriatum. We report the case of a 14-year-old boy who was undergoing surgery for correction of a secundum atrial septal defect. Intraoperatively, we discovered that he had a levoatrial cardinal vein and no brachiocephalic vein. However, collateral vessels provided adequate flow to the right atrium, and the patient's left-sided venous pressure was not excessive, so we ligated the levoatrial cardinal vein and directly repaired the septal defect. Postoperatively, the left venous drainage was satisfactory and the patient was asymptomatic. In addition to our patient's case, we discuss the embryology, diagnosis, and treatment of levoatrial cardinal vein.

Keywords: Heart atria/abnormalities/surgery; heart defects, congenital/surgery; treatment outcome.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Brachiocephalic Veins / abnormalities*
  • Brachiocephalic Veins / diagnostic imaging
  • Brachiocephalic Veins / physiopathology
  • Brachiocephalic Veins / surgery*
  • Cardiac Surgical Procedures*
  • Collateral Circulation
  • Heart Septal Defects, Atrial / complications
  • Heart Septal Defects, Atrial / surgery*
  • Hemodynamics
  • Humans
  • Incidental Findings
  • Intraoperative Period
  • Ligation
  • Male
  • Radiography
  • Regional Blood Flow
  • Treatment Outcome
  • Vascular Malformations / complications
  • Vascular Malformations / diagnostic imaging
  • Vascular Malformations / physiopathology
  • Vascular Malformations / surgery*

Supplementary concepts

  • Atrial Septal Defect, Secundum Type