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Long-term outcome after percutaneous closure of persistent left superior caval vein draining into the left atrium: a contrast-enhanced CT study

Published online by Cambridge University Press:  08 May 2017

Davide Marini ,
Matteo Castagno ,
Michele Millesimo ,
Francesca Ferroni ,
Gaetana Ferraro ,
Carlo Pace Napoleone  and
Gabriella Agnoletti
Davide Marini*
Affiliation:
Division of Pediatric Cardiology, Ospedale Infantile Regina Margherita, Citta’ della Salute e della Scienza di Torino, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
Matteo Castagno
Affiliation:
Division of Pediatric Cardiology, Ospedale Infantile Regina Margherita, Citta’ della Salute e della Scienza di Torino, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
Michele Millesimo
Affiliation:
Division of Pediatric Cardiology, Ospedale Infantile Regina Margherita, Citta’ della Salute e della Scienza di Torino, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
Francesca Ferroni
Affiliation:
Division of Pediatric Cardiology, Ospedale Infantile Regina Margherita, Citta’ della Salute e della Scienza di Torino, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
Gaetana Ferraro
Affiliation:
Division of Pediatric Cardiology, Ospedale Infantile Regina Margherita, Citta’ della Salute e della Scienza di Torino, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
Carlo Pace Napoleone
Affiliation:
Division of Pediatric Cardiology, Ospedale Infantile Regina Margherita, Citta’ della Salute e della Scienza di Torino, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
Gabriella Agnoletti
Affiliation:
Division of Pediatric Cardiology, Ospedale Infantile Regina Margherita, Citta’ della Salute e della Scienza di Torino, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
*
Correspondence to: D. Marini, MD, PhD, Division of Pediatric Cardiology, Ospedale Infantile Regina Margherita, Città della Salute e della Scienza, University of Turin, Corso Spezia 60, 10126, Torino, Italy. Tel: +0039 011 313 1556; Fax: +0039 011 313 5482; E-mail: dmarini@cittadellasalute.to.it
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Abstract

Background

Data regarding long-term outcome after percutaneous closure of left superior caval vein draining into the left atrium are lacking. The aim of the present study was to report the long-term follow-up by using contrast-enhanced CT.

Methods

In all, three patients underwent percutaneous closure of left superior caval vein draining into the left atrium between 2005 and 2015. All of them were evaluated clinically and underwent contrast-enhanced CT.

Results

In one patient, the Amplatzer® Septal Occluder was used. In two patients, the Amplatzer® Vascular Plug type-1 was preferred: the device size/LSVC diameter ratio was 1.7 in the child and 1.2 in the adult. There were no early-onset or long-term onset complications. CT was performed 1, 2, and 10 years after the procedure, respectively. Complete occlusion of the vessel was documented in all. After 10 years since the procedure, CT revealed a persistent trivial residual shunt through the accessory hemiazygos vein in one patient, in whom the device was implanted above its drainage into the left superior caval vein. When an Amplatzer® Vascular Plug type-1 is oversized compared with the venous vessel diameter, it immediately assumes a dog-bone shape that disappears early to regain its shape memory and nominal size.

Conclusions

Percutaneous occlusion of left superior caval vein draining into the left atrium has excellent early and long-term outcomes. The optimal implantation of the device is below the drainage of the accessory hemiazygos vein, when present. The device might be oversized compared with the left superior caval vein diameter according to the age of the patient.

Keywords

CTleft superior caval veinembolisationcyanosis
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 8 , October 2017 , pp. 1550 - 1556
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Copyright
© Cambridge University Press 2017 

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