Abstract
A 19 years old patient presented with complaints of shortness of breath on mild exertion,
stabbing pain in the heart, fatigue. Echocardiography revealed a secondary ASD 25 mm, no
roof and enalarged of coronary sinus, persistent left superior vena cava (PLSVC) drainage into
the left atrium, the moderate insufficiency of mitral and tricuspid valves.
According to the contrast-enhanced chest CT: PLSVC drainage near the appendage of the left
atrium, missing left brachiocephalic vein. An unusual finding was an anomalous left hepatic
vein drainage into the coronary sinus.
Operation was performed under cardiopulmonary bypass and antegrade cardioplegia.
Correction of this abnormalities consisted of: the mitral annuloplasty with the polypropylene
suture reinforced with pledgets at each commissure and at the centre point of the posterior
leaflet. Annuloplasty of tricuspid valve for DeVega; create intraatrial tunnel using xenopericardial
patch to allow the PLSVC draining into the right atrium, and ASD closure.
Patient discharged on postoperative day 8. Left ventricular ejection fraction was 70%.
Preoperative diagnosed of PLSVC and anomalous left hepatic vein drainage made possible to
avoid technical difficulties during surgery. Operation of creating intraatrial tunnel demonstrated
a good clinical outcome.
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