Gananjay G. Salve, MCh, Shreepal A. Jain, MD, Bhavesh M

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Presentation transcript:

Right Posterior Thoracotomy for Open-Heart Surgery in a Rare Morphology Gananjay G. Salve, MCh, Shreepal A. Jain, MD, Bhavesh M. Thakkar, DM, Krishnanaik Shivaprakash, MCh The Annals of Thoracic Surgery Volume 103, Issue 1, Pages e107-e109 (January 2017) DOI: 10.1016/j.athoracsur.2016.07.029 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Two-dimensional image of subcostal four-chamber view demonstrating the atrial septal defect (asterisk) and dilated coronary sinus (CS). (B) Postoperative two-dimensional image of subcostal four-chamber view showing the atrial septal defect (ASD) patch in situ. (C) Two-dimensional and color-compare images of suprasternal short axis view, demonstrating the innominate vein (Inn. vein) draining into the left superior vena cava (LSVC). (LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle.) The Annals of Thoracic Surgery 2017 103, e107-e109DOI: (10.1016/j.athoracsur.2016.07.029) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Contrast-enhanced computed tomographic scan showing left superior vena cava (LT SVC) draining into the right atrium (RA). (B) Contrast-enhanced computed tomographic scan with three-dimensional volume rendered reconstruction showing isolated left superior vena cava (LSVC), and the innominate vein (Inn. V) joining it from the right side. (IVC = inferior vena cava; RA = right atrium.) The Annals of Thoracic Surgery 2017 103, e107-e109DOI: (10.1016/j.athoracsur.2016.07.029) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A) Intraoperative photograph showing absent right superior vena cava (arrow). (B) Intraoperative photograph showing the separate incision with inferior vena caval (IVC) cannula threaded through it (black arrow). The same cannula has been inserted and fixed into the IVC (white arrow). (C) Sketch diagram showing the intraoperative procedure. Note the novel technique of inferior vena cava (IVC) cannulation (bold arrow). Right superior vena cava is absent (arrow). Coronary sinus (CS) is dilated. The aortic cross clamp and vent into the CS are not shown in the diagram for simplification. (Ao = aorta; RA = right atrium.) The Annals of Thoracic Surgery 2017 103, e107-e109DOI: (10.1016/j.athoracsur.2016.07.029) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions