tailieunhanh - Báo cáo y học: "The importance of localizing pulmonary veins in atrial septal defect closure"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: The importance of localizing pulmonary veins in atrial septal defect closure! | Amirghofran et al. Journal of Cardiothoracic Surgery 2011 6 41 http content 6 1 41 JCTS JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access The importance of localizing pulmonary veins in atrial septal defect closure Ahmad Ali Amirghofran1 Ashkan Karimi2 Gholam Hossein Ajami3 and Alireza Rasekhi4 Abstract An 8-year-old girl was admitted for a simple closure of echocardiographically diagnosed Atrial Septal Defect ASD . During the operation the right pulmonary veins orifices were not detected in the left atrium and attempt to localize them led to the discovery of three additional anomalies namely Interrupted Inferior Vena Cava IIVC Scimitar syndrome and systemic arterial supply of the lung. Postoperatively these finding were confirmed by CT angiography. This case report emphasizes the need for adequate preoperative diagnosis and presents a very rare constellation of four congenital anomalies that to the best of our knowledge is not reported before. Background The need for adequate preoperative diagnosis in the field of congenital heart surgery cannot be overemphasized. To this end many centers routinely use Intraoperative Trans-Esophageal Echocardiography ITEE . Mayo clinic group in a study of 1002 congenital heart disease patients demonstrated that ITEE had maj or impact in of cases defined as revealing any undetected pre or intaoperative information requiring an otherwise non-performed procedure during the surgery however the ASD secundum subset 67 cases was the only primary diagnosis in this study that ITEE had zero major impact on and routine ITEE did not seem to be cost effective in this group 1 . In our experience also a comprehensive preoperative Trans-Thoracic Echocardiography TTE is considered adequate for delineation of simple cardiac defects such as ASD secundum unless the cardiologist is not satisfied with the quality of the study in which case preoperative TEE cardiac MRI or ITEE is considered. In contrast to what

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