By L.K. von Segesser, Antonio F. Corno
Expressly created to aid with determination making for surgical procedure of congenital center defects, this new reference covers all appropriate aspects.
The congenital center defects are provided with each one bankruptcy dedicated to a unmarried malformation, with prevalence, morphology, linked anomalies, pathophysiology, prognosis (including scientific development, electrocardiogram, chest X-ray, echocardiogram, cardiac catheterization with angiography), symptoms for surgical operation, info of surgery, strength problems and literature references.
Morphology, pathophysiology and surgical operation of the defects are defined with schematic drawings, whereas photographs taken from morphologic specimens, echocardiographic and angiographic investigations in addition to from intra-operative images illustrate larger than any words the most important issues of the decision-making method for the surgical procedure of congenital center defects.
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Extra info for Congenital Heart Defects: Decision Making for Surgery, Vol. 1
Exposure of this portion of the vein is afforded by splitting the diaphragm to the veno-caval hiatus. In some patients, the repair may only require removal of the inferior vena cava cannula to expose the anomalous venous ostium during a brief period of deep hypothermic circulatory arrest. In this instance, an intraatrial baffle is used in much the same way as a partial anomalous venous connection with a sinus venosus defect. A final alternative technique consists of extracardiac reimplantation of the scimitar vein into the posterior wall of the right atrium followed by transposition of the atrial septum anterior to the new ostium, either directly or with a patch.
Sinus venosus atrial septal defects are treated by patch closure of the defect, leaving the right pulmonary veins on the left side of the patch, with unrestricted communication with the left atrium, and avoiding damage to the sinus node (and the sinus node artery) by the suture line (see chapter “Partial anomalous pulmonary venous connection”). 36 z Atrial septal defect z Pre-operative information Ostium secundum atrial septal defect is usually sufficiently evaluated, mainly in children, by transthoracic echocardiography for diagnosis and indication to management, even if percutaneous transcatheter occlusion of secundum atrial septal defects has increased the need for accurate anatomic information of the defect size, morphology, and spatial relationships.
The inferior systemic venous return drains principally into the superior vena cava through a dilated azygos and hemiazygos veins as shown from maximal intensity projection (c = posterior view). In a, note that there are some suprahepatic veins draining into the PTFE scimitar-to-left atrium conduit, leading to mild systemic oxygen desaturation. In the volume rendering imaging (d = anterior view) note the “kinking” of the baffle-scimitar anastomosis (IVC inferior vena cava, LA left atrium, RA right atrium, SVC superior vena cava) z References Amodeo A, Corno AF, Marino B, Carta MG, Marcelletti C (1990) Combined repair of transposed great arteries and total anomalous pulmonary venous connecion.