Systemic and pulmonary venous connections in visceral heterotaxy with asplenia: Diagnostic and surgical considerations based on seventy-two autopsied.

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Systemic and pulmonary venous connections in visceral heterotaxy with asplenia: Diagnostic and surgical considerations based on seventy-two autopsied cases Maurizio Rubino, MD*, Stella Van Praagh, MD, Keishi Kadoba, MD, Renzo Pessotto, MD*, Richard Van Praagh, MD The Journal of Thoracic and Cardiovascular Surgery Volume 110, Issue 3, Pages 641-650 (September 1995) DOI: 10.1016/S0022-5223(95)70095-1 Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 1 Diagrammatic presentation of systemic venous connections in 72 cases of visceral heterotaxy with asplenia. Normal CoS was present in two cases (column 1). Vertical columns outline difference in size between two SVCs (equal: columns 1 and 2; unequal: columns 3 and 4; one atretic: column 5; single: column 6). Horizontal rows outline absence (rows A, B,C, D) or presence (rows E, F, G, H) of separate drainage of the hepatic veins and the relationship between IVC and larger of two SVCs (ipsilateral: rows A, C, E, F, G; contralateral: rows B, D, H). HV, hepatic veins; LA, morphologically left atrium; LSVC, left SVC; RA, morphologically right atrium; RSVC, right SVC. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 641-650DOI: (10.1016/S0022-5223(95)70095-1) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 2 Diagrammatic presentation of systemic and pulmonary venous connections in 30 cases of visceral heterotaxy with asplenia associated with total or partial cardiac pulmonary venous connections (groups A and B). In cases 1 through 12 pulmonary veins connect with heart normally via four orifices in posterior atrial wall. In cases 13 through 28 pulmonary veins connect with atrial segment of heart via single or double orifice (incomplete incorporation of common pulmonary vein). In cases 29 and 30 pulmonary veins connect partly with atria and partly with SVC. Arrows indicate sites of obstruction of pulmonary venous drainage. PV, Pulmonary veins; LACV, levoatrial cardinal vein. Other abbreviations as in Fig. 1. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 641-650DOI: (10.1016/S0022-5223(95)70095-1) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 3 Diagrammatic presentation of systemic and pulmonary venous connections in 42 cases of visceral heterotaxy with asplenia associated with extra cardiac pulmonary venous connections (group C). In case 31 abnormal pulmonary venous connections are mixed, partly to azygos vein and partly to IVC. In cases 32 through 61 abnormal pulmonary venous connections are supracardiac and in cases 62 through 72 they are subdiaphragmatic. Arrows show sites of obstruction of pulmonary venous drainage. Abbreviations as in Fig. 1. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 641-650DOI: (10.1016/S0022-5223(95)70095-1) Copyright © 1995 Mosby, Inc. Terms and Conditions