Incidental Vascular Findings in Computed Tomography Performed in the Qualification for the TAVI Procedure
Abstract
:- Incidental vascular finding No. 1: Persistent Left Superior Vena Cava with Absent Right Superior Vena Cava.
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- Difficulty inserting central venous cannula, pulmonary artery catheter, and transvenous pacing leads through the left internal jugular/subclavian vein. The dilated coronary sinus (CS), which is thin-walled and stretched, predisposes it to perforation, tamponade, various arrhythmias, and cardiac arrest.
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- Persistent left SVC may require separate cannulation during right-sided open-heart surgical procedures, either directly or through CS.
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- Difficulty in performing cavo-pulmonary anastomoses.
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- Inability to deliver retrograde cardioplegia during open-heart surgery and port-access cardiac surgery because of the large size of CS.
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- Rhythm abnormalities such as ectopic atrial rhythm, wandering pacemaker, first-degree atrioventricular block, tachyarrhythmia, and complete heart block because of the stretching or fragmentation of the atrioventricular node and His bundle secondary to the dilatation of CS. Sinoatrial nodal abnormalities have been detected in patients with absent right SVC, predisposing the patient to sick sinus syndrome.
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- Rarely, enlarged CS can impinge on the vestibule of the mitral valve that may produce obstruction to left ventricular inflow.
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- An orthotopic heart transplant may require the recipient’s heart to be excised along the atrioventricular grove, preserving the persistent left superior vena cava and CS [9].
- Incidental vascular finding No. 2: Right Aortic Arch.
- Incidental vascular finding No. 3: Ectopic Right Coronary Artery Ostium.
- Incidental vascular finding No. 4: Left Superior Pulmonary Vein Draining into Left Brachiocephalic Vein.
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Gać, P.; Grochulska, A.; Poręba, R. Incidental Vascular Findings in Computed Tomography Performed in the Qualification for the TAVI Procedure. Diagnostics 2022, 12, 2773. https://doi.org/10.3390/diagnostics12112773
Gać P, Grochulska A, Poręba R. Incidental Vascular Findings in Computed Tomography Performed in the Qualification for the TAVI Procedure. Diagnostics. 2022; 12(11):2773. https://doi.org/10.3390/diagnostics12112773
Chicago/Turabian StyleGać, Paweł, Aleksandra Grochulska, and Rafał Poręba. 2022. "Incidental Vascular Findings in Computed Tomography Performed in the Qualification for the TAVI Procedure" Diagnostics 12, no. 11: 2773. https://doi.org/10.3390/diagnostics12112773
APA StyleGać, P., Grochulska, A., & Poręba, R. (2022). Incidental Vascular Findings in Computed Tomography Performed in the Qualification for the TAVI Procedure. Diagnostics, 12(11), 2773. https://doi.org/10.3390/diagnostics12112773