The persistent left superior vena cava among children with congenital heart disease; The frequency and the outcomes: A single center experience
Code: G-09472
Authors: Parisa Qayenipour ℗, Mohammad Mahdi Alvandi Fard, Hassan Mottaghi Moghaddam Shahri ©, Ali Mottaghi Moghaddam Shahri, Mohammad Reza Naghibi Sistani, Shirin Ghiasi, Mahmoud Hoseinzadeh Maleki, Mahdi Kahrom
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Abstract:
Background
The persistent left-sided superior vena cava (LSVC) is the most common chest abnormality and is mostly detected in patients with CHDs. It leads to cyanosis as well as the interventional and surgical complications. To the best of our knowledge, there is limited studies of LSVC in Northeast Iran, we aimed to focus on the frequency and outcomes of persistent LSVC in children with CHDs.
Methods
This retroperspective cohort study was conducted on all patients with LSVC, referred to the CHD clinic in Imam Reza Hospital, Mashhad-Iran from years 2011 to 2018. We collected demographic and clinical information of 237 patients. Demographic data were categorized. Heart complications were divided into major and minor categories based on the need for more follow-up and interventions. Data was analyzed using SPSS version 16.5.
Results
The study was conducted on 237 children which 55% were boys. The average age of patients’ first referral was 10.7 months. Prematurity and low birth weight (2500gr) were observed in 5.5% and 28% of patients, respectively. The patients were diagnosed mostly with major cardiac diseases (90%), who were referred at younger ages (p0.05). One third of the patients were delivered by cesarean section. The most common major cardiac abnormalities were complex CHD (39.5%), septal defects (31.4%), obstructive right heart defects (18.6%), left side obstructive diseases (8.5%), and patent ductus arteriosus (7%). The most common minor cardiac diseases included floppy mitral valve and patent foramen ovale. Intervention and surgery were undergone in 2% & 36% of the patients. Reoperation were required in three cases due to unroofed coronary sinus and in one case due to persistent cyanosis after the Fontan operation. Neuropsychiatric, urogenital, musculoskeletal, and gastrointestinal malformations were the most non-cardiac associations.
Conclusions
Persistent LSVC is more common in CHD cases, particularly complex CHD. Failure in diagnosis might result in post cardiac operation cyanosis. Paying attention on coronary sinus dilation as well as the structural anomalies are the most significant point in diagnosis.
Keywords
LSVC, CHD, Congenital Heart Disease