AUTHOR=Corno Antonio F., Alahdal Sami A., Das Karuna M.

TITLE=Systemic venous anomalies in the Middle East

JOURNAL=Frontiers in Pediatrics

VOLUME=1

YEAR=2013

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2013.00001

DOI=10.3389/fped.2013.00001

ISSN=2296-2360

ABSTRACT=<p><bold>Introduction:</bold> Systemic venous anomalies are quite rare and can be associated with congenital heart disease requiring surgery.</p><p><bold>Materials and Methods:</bold> All consecutive patients (pts) undergoing surgery for congenital heart defects were retrospectively analyzed for presence of systemic venous anomalies:
<list list-type="simple"><list-item><p>(a) Persistent left superior vena cava (PLSVC)</p></list-item><list-item><p>(b) Inferior vena cava (IVC) interruption</p></list-item><list-item><p>(c) Retro-aortic innominate vein</p></list-item></list></p><p><bold>Results:</bold> From 9/2010 to 5/2012 155 pts, median age 7 months, mean age 1.3 years (3 days–50 years), median weight 4 kg, mean weight 7.2 kg (0.6–110 kg) underwent congenital heart surgery. Twenty-nine systemic venous anomalies were identified in 28/155 patients (=18.1%). PLSVC was present in 21 pts (=13.5%), median age 4 months, mean age 2.7 years (3 days–22 years), median weight 6 kg, mean weight 10.1 kg (2.4–43.0 kg). IVC interruption was identified in 5 pts (=3.2%), median age 2 months, mean age 5.4 years (30 days–26 years), median weight 3.7 kg, median weight 17 kg (2.3–68.0 kg). Retro-aortic innominate vein was diagnosed in 3 pts (=1.9%), median age 5 years, mean age 3.7 years (10 months–5 years), median weight 12 kg, mean weight 10.1 kg (4.5–14 kg). Complete pre-operative diagnosis was obtained in 14/28 (=50%) pts with echocardiography and in other 8/28 (=28.6%) only after computed tomography (CT) scan, for a total of 22/28 (=78.6%) correct pre-operative diagnosis. In 6/28 (=21.4%) patients the diagnosis was intra-operative. Total incidence of systemic venous anomalies was 18.1% (vs. 4% in the literature, <italic>P</italic> = 0.0009), with presence of PLSVC = 13.5% (vs. 0.3–4.0%, respectively <italic>P</italic> = 0.0004 and <italic>P</italic> = 0.0012), IVC interruption = 3.2% (vs. 0.1–1.3%, N.S.), and retro-aortic innominate vein = 1.9% (vs. 0.2–1%, N.S.).</p><p><bold>Conclusions:</bold> Our study showed an incidence of systemic venous anomalies in Middle Eastern pts with congenital heart defects higher than previously reported. In 78.6% of pts the diagnosis was correctly made before surgery (echocardiography or CT scan), with 21.4% of complete diagnosis made at surgery. A careful pre-operative screening should be performed in all pts with congenital heart defects from this region to better identify all systemic venous anomalies for a more accurate surgical planning.</p>