J Chest Surg.  2021 Jun;54(3):214-217. 10.5090/jcs.20.037.

Levoatrial Cardinal Vein: Occluder Embolization and Complication Management

Affiliations
  • 1Departments of Pediatric Heart Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
  • 2Departments of Pediatric Cardiology, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey

Abstract

In rare cases, levoatrial cardinal vein may occur as an isolated condition without additional congenital anomalies. Depending on the direction and flow of the shunt, this pathology may produce symptoms; alternatively, it may be asymptomatic, as in the case presented in this study. In asymptomatic cases, complications, such as paradoxical embolism and brain abscess, can arise later. In the 11-year-old patient whose case is presented here, the levoatrial cardinal vein was asymptomatic and incidentally detected. The percutaneous closure method was applied first. However, by 16 hours after the procedure, the occluder device had embolized to the iliac artery. Emergency surgery was performed; first, the occluder device was removed, and levoatrial cardinal vein ligation was then performed via a mini-thoracotomy. The symptoms, diagnosis, and treatment modalities of isolated levoatrial cardinal vein are discussed in the context of this case described herein.

Keyword

Vascular malformations; Embolization; Therapeutic; Minimally invasive surgical procedures
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