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Diversion of the Inferior Vena Cava Following Repair of Atrial Septal Defect Causing Hypoxemia
Author(s) -
Thompson Ellen,
Moritz Dennis,
Perdue Romaine,
Cansino Silvestre
Publication year - 2004
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.0742-2822.2004.02089.x
Subject(s) - medicine , basilic vein , shunt (medical) , inferior vena cava , complication , surgery , hypoxemia , cardiology , femoral vein , vein
Atrial septal defects (ASDs) are a common congenital abnormality, and operative repair is a routine, safe procedure. Diversion of the inferior vena cava (IVC) into the left atrium is an unusual complication following ASD closure. We report a case that illustrates the problem created by this right‐to‐left shunt. A middle‐aged woman underwent ASD repair. She developed hypoxemia postoperatively. A transthoracic echocardiogram confirmed a right‐to‐left shunt, found only with agitated saline injected into the femoral vein, not into the basilic vein. Surgical reexploration revealed a residual ASD diverting IVC flow into the left atrium, which was repaired with a pericardial patch. Echocardiography with agitated saline injected from the femoral vein is an easy method to diagnose this uncommon complication. (ECHOCARDIOGRAPHY, Volume 21, May 2004)