PubMed · 14868912
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J A FERREIRA, E J F VILLAMIL, A O CIRUZZI. 1951. Dynamic phlebography.. https://doi.org/10.1177/000331975100200504
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Early or multiple cardiac catheterizations may result in occlusion of the femoral veins prohibiting their use. The internal jugular or sub-clavian approach may be an appropriate alternative. However, these approaches may not be suitable in patients with surgical interruption of the superior vena cava. In other patients, they may not allow easy access to certain areas of the heart. The transhepatic approach is an important alternative route for performing cardiac catheterization and interventions. Depending on the planned procedure, it may be the preferred route to perform the cardiac catheterization even in the presence of patent femoral veins. The indications, technical details and potential complications of this approach are discussed.
The most commonly encountered systemic thoracic venous anomaly is a persistent left superior vena cava that drains into the right atrium via the coronary sinus. A much rarer systemic venous anomaly is that of isolated anomalous drainage of a normally positioned right superior vena cava (RSVC) into the left atrium (LA). This has been reported in approximately 20 patients with the diagnosis usually being made by cardiac catheterization. We report the case of a toddler with asymptomatic hypoxemia resulting from anomalous drainage of a normal RSVC into his LA. This was diagnosed non-invasively by contrast-enhanced chest CT.
STUDY DESIGN: Prospective cohort. OBJECTIVE: To determine the efficacy of a single-slice computed tomography (CT) angiogram to define the prevertebral anatomy in patients undergoing an anterior lumbar spine procedure. SUMMARY OF BACKGROUND DATA: Preoperative planning with precise prevertebral anatomic details can help in mini-open anterior lumbar approaches. METHODS: A total of 76 consecutive patients undergoing a minimal incision approach for anterior lumbar surgery were evaluated before surgery with CT angiography. The prevertebral anatomy was documented, and the patients were observed during treatment. RESULTS: There were no complications related to CT angiography. This study directly influenced surgical decision making and the treatment options in 21% of patients. The vena caval confluence limited access to the L5-S1 disc in 3% of patients and at the L4-L5 disc in 92% of the patients. Prevertebral anatomic anomalies were found in 11.8% of patients. Atherosclerotic disease was discovered in 17% of the patients. The major complication rate was 7.5%. CT angiography correlated with intraoperative vascular anatomy in all cases. CONCLUSION: Preoperative CT angiography before anterior approaches was determined to be effective in evaluating the prevertebral vascular anatomy.