Texas Heart Institute journal
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Case Reports
Meandering right pulmonary vein to the left atrium and inferior vena cava: the first case with associated anomalies.
We report a case of a healthy, asymptomatic 6-year-old boy in whom an anomalous right pulmonary vein was noted to drain into both the inferior vena cava and left atrium in association with findings consistent with scimitar syndrome. The anomalous pulmonary vein took a very circuitous route through the lungs before draining into the left atrium, a condition previously termed "meandering pulmonary vein." To aid in the diagnosis, cardiovascular magnetic resonance imaging and magnetic resonance angiography were used to delineate this complex course and the connection of the anomalous pulmonary vein. To our knowledge, this is the 1st reported case of a meandering pulmonary vein with dual drainage to the inferior vena cava and left atrium in association with other anomalies.
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The eustachian valve is an embryologic remnant of the valve of the inferior vena cava. It may be prominent in some individuals, but the echocardiographic appearance of a divided right atrium, as the consequence of a large eustachian valve, is extremely rare. Herein we describe an unusual giant eustachian valve with an echocardiographic appearance of a septal structure dividing the right atrium into 2 separate chambers. This abnormality should be differentiated from cor triatriatum dexter, a very rare cardiac malformation for which it could be mistaken.
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We report a case of a 36-year-old man who developed a lung hernia after a minimally invasive mitral valve repair. Lung hernias are uncommon. Most are acquired and may be classified as traumatic, spontaneous, pathologic, or postoperative. ⋯ Our review of the literature revealed only 2 reports of this sequela in association with this surgical procedure. Repair was performed due to persistent symptoms, including pleurisy and dyspnea, and interference with the patient's daily activities. Surgical repair led to complete resolution of these problems.
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We report herein a rare case of complete congenital sternal cleft (absent sternum) and anterior pericardial defect in association with pectus excavatum. In neonates with absent sternum, the sternal bars can be easily approximated by simple suture, due to the flexibility of the cartilaginous thorax. There is also little danger of cardiac compression when the repair is performed early in life. ⋯ After surgical correction of the pectus excavatum, we were able to construct a sternum by incising the lateral border of each sternal bar, thereby creating flaps that we sutured together at midline. The sternal bars were then approximated by loops of nonabsorbable suture around their circumference. The patient had an uncomplicated course, and at the 12-month follow-up visit, her sternal appearance was normal.