Images in Cardiothoracic Medicine and Surgery
Pulmonary vein stenosis in a child with ventricular septal defect
Asian Cardiovascular & Thoracic Annals 2014, Vol. 22(9) 1130–1131 ß The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492313513600 aan.sagepub.com
Sarvesh Pal Singh, Poonam Malhotra Kapoor and Velayoudham Devagourou
Figure 1. Color Doppler in mid esophageal modified bicommissural view showing a discrete membrane obstructing the opening of left superior pulmonary vein (LSPV).
Figure 2. Color Doppler in mid esophageal modified bicommissural view showing no obstruction to blood flow from the left superior pulmonary vein after resection of the membrane.
A 1-year-old boy presented with a history of recurrent episodes of upper respiratory tract infection since birth. On the basis of clinical examination, electrocardiography and transthoracic echocardiography, he was diagnosed with perimembranous ventricular septal defect and severe pulmonary hypertension. Intraoperatively, a large perimembranous ventricular septal defect of 12.5 mm was seen on transesophageal
Figure 3. Continuous-wave Doppler showing a gradient of 23 mm Hg across the obstructing membrane.
Figure 4. Continuous-wave Doppler showing a gradient of 7 mm Hg across left superior pulmonary vein after intracardiac repair.
Cardio-Thoracic Sciences Center, All India Institute of Medical Sciences, New Delhi, India Corresponding author: Sarvesh Pal Singh, MD, Department of Cardiac Anaesthesia, 7th Floor, Room 10A, All India Institute of Medical Sciences, New Delhi 110029, India. Email: [email protected]
Downloaded from aan.sagepub.com at SUNY HEALTH SCIENCE CENTER on March 22, 2015
Singh et al.
1131
echocardiography. Detailed examination revealed a membrane at the ostium of the left superior pulmonary vein in the left atrium. Color Doppler examination showed turbulence in the course of the left superior pulmonary vein (Figure 1). Continuous-wave Doppler showed a gradient of 23 mm Hg across this membrane (Figure 2). After intracardiac repair of the ventricular septal defect and excision of the stenotic membrane, there was no turbulence in the course of the left superior pulmonary vein (Figure 3) and the gradient across it decreased to 7 mm Hg (Figure 4). The child was
extubated after 6 h and discharged from the hospital on the 5th postoperative day. On the first follow-up visit, he was doing well with no complaints. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Conflicts of interest statement None declared.
Downloaded from aan.sagepub.com at SUNY HEALTH SCIENCE CENTER on March 22, 2015
Pulmonary vein stenosis in a child with ventricular septal defect
Asian Cardiovascular & Thoracic Annals 2014, Vol. 22(9) 1130–1131 ß The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492313513600 aan.sagepub.com
Sarvesh Pal Singh, Poonam Malhotra Kapoor and Velayoudham Devagourou
Figure 1. Color Doppler in mid esophageal modified bicommissural view showing a discrete membrane obstructing the opening of left superior pulmonary vein (LSPV).
Figure 2. Color Doppler in mid esophageal modified bicommissural view showing no obstruction to blood flow from the left superior pulmonary vein after resection of the membrane.
A 1-year-old boy presented with a history of recurrent episodes of upper respiratory tract infection since birth. On the basis of clinical examination, electrocardiography and transthoracic echocardiography, he was diagnosed with perimembranous ventricular septal defect and severe pulmonary hypertension. Intraoperatively, a large perimembranous ventricular septal defect of 12.5 mm was seen on transesophageal
Figure 3. Continuous-wave Doppler showing a gradient of 23 mm Hg across the obstructing membrane.
Figure 4. Continuous-wave Doppler showing a gradient of 7 mm Hg across left superior pulmonary vein after intracardiac repair.
Cardio-Thoracic Sciences Center, All India Institute of Medical Sciences, New Delhi, India Corresponding author: Sarvesh Pal Singh, MD, Department of Cardiac Anaesthesia, 7th Floor, Room 10A, All India Institute of Medical Sciences, New Delhi 110029, India. Email: [email protected]
Downloaded from aan.sagepub.com at SUNY HEALTH SCIENCE CENTER on March 22, 2015
Singh et al.
1131
echocardiography. Detailed examination revealed a membrane at the ostium of the left superior pulmonary vein in the left atrium. Color Doppler examination showed turbulence in the course of the left superior pulmonary vein (Figure 1). Continuous-wave Doppler showed a gradient of 23 mm Hg across this membrane (Figure 2). After intracardiac repair of the ventricular septal defect and excision of the stenotic membrane, there was no turbulence in the course of the left superior pulmonary vein (Figure 3) and the gradient across it decreased to 7 mm Hg (Figure 4). The child was
extubated after 6 h and discharged from the hospital on the 5th postoperative day. On the first follow-up visit, he was doing well with no complaints. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Conflicts of interest statement None declared.
Downloaded from aan.sagepub.com at SUNY HEALTH SCIENCE CENTER on March 22, 2015
