Anatomical Left Superior Vena Cava Correction: An Option for Left Ventricular Recruitment?

Bieling F, Cesnjevar RA, Cuomo M, Weigelt A, Dittrich S, Purbojo A (2025)

Publication Type: Journal article

Publication year: 2025

Journal

Thoracic and Cardiovascular Surgeon Georg Thieme Verlag

Book Volume: 73

Pages Range: e21-e30

Journal Issue: S 03

DOI: 10.1055/a-2531-3126

Abstract

Left superior vena cava (LSVC)-related obstruction of mitral inflow is a rare condition in patients with complex cardiac anomalies like hypoplastic left heart complex. We report on the impact of establishing LSVC to right superior vena cava (RSVC) continuity on the growth of borderline hypoplastic left ventricular structures as an addendum to our previously published work.Twenty-two patients underwent LSVC to RSVC anastomosis, whereas six had LSVC ligation (n = 4) or clip closure (n = 2), all alongside congenital heart defect correction. The indication was LSVC-related obstruction of left ventricular inflow due to a dilated coronary sinus. Clinical data were systematically reviewed, with regular follow-up. Left ventricular end diastolic diameters (LVEDD), aortic valve diameters, and left ventricular outflow tract (LVOT) diameters were recorded using echocardiography.Follow-up showed 90% survival at 3.3 ± 0.4 years. Mean LVEDD Z-scores improved from -2.19 ± 0.35 to -1.24 ± 0.26 after repair (p < 0.01) and to -1.33 ± 0.56 at 6-month follow-up. In patients without mitral repair, LVEDD Z-scores improved from -2.11 ± 0.62 preoperatively to -1.85 ± 0.88 postoperatively (p < 0.05). LVOT Z-scores increased from -2.49 ± 0.48 to -0.87 ± 0.75 (p < 0.05) and aortic valve Z-scores improved from -1.08 ± 0.57 to 0.5 ± 0.39 over 24 months (p < 0.05).Anatomical LSVC correction may improve left ventricular filling and growth of the left ventricle, aortic valve, and LVOT in patients with borderline left ventricles and could be considered without as a potential recruitment strategy.

Authors with CRIS profile

Frederike Bieling Department of Paediatric Surgery Michela Cuomo Department of Paediatric Cardiac Surgery Annika Weigelt Department of Paediatric Cardiology Sven Dittrich Department of Paediatric Cardiology Ariawan Purbojo Department of Paediatric Cardiac Surgery

Involved external institutions

Universitäts-Kinderspital Zürich CH Switzerland (CH)

How to cite

APA:

Bieling, F., Cesnjevar, R.A., Cuomo, M., Weigelt, A., Dittrich, S., & Purbojo, A. (2025). Anatomical Left Superior Vena Cava Correction: An Option for Left Ventricular Recruitment? Thoracic and Cardiovascular Surgeon, 73(S 03), e21-e30. https://doi.org/10.1055/a-2531-3126

MLA:

Bieling, Frederike, et al. "Anatomical Left Superior Vena Cava Correction: An Option for Left Ventricular Recruitment?" Thoracic and Cardiovascular Surgeon 73.S 03 (2025): e21-e30.

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