Atrial septal defects (ASDs) are a common congenital abnormality, and operative repair is a routine, safe procedure. Diversion of the inferior vena cava (IVC) into the left atrium is an unusual complication following ASD closure. We report a case that illustrates the problem created by this right-to-left shunt. A middle-aged woman underwent ASD repair. She developed hypoxemia postoperatively. A transthoracic echocardiogram confirmed a right-to-left shunt, found only with agitated saline injected into the femoral vein, not into the basilic vein. Surgical reexploration revealed a residual ASD diverting IVC flow into the left atrium, which was repaired with a pericardial patch. Echocardiography with agitated saline injected from the femoral vein is an easy method to diagnose this uncommon complication.
Diversion of the inferior vena cava following repair of atrial septal defect causing hypoxemiaInternal Medicine
Citation InformationThompson, E., Moritz, D., Perdue, R., & Cansino, S. (2004). Diversion of the inferior vena cava following repair of atrial septal defect causing hypoxemia. Echocardiography, 21(4), 329-332.