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Recanalized Vein of Marshall Following Bidirectional Glenn Surgery

Sourabh Agstam, MBBS, MD, DM; Lydia John, MBBS, MD; Sivasubramanian Ramakrishnan, MD, DM; Saurabh Kumar Gupta, MD, DM

10/25/2023
Video 1. Selective angiogram of a large venovenous channel(arrowheads)connecting the innominate vein with the coronary sinus(arrow). This venovenous collateral is actually the recanalized vein of Marshall, a remnant of the left superior vena cava

 

Video 2. Preoperative innominate vein angiogram before the BDG showed a small rudimentarynon-flowing vein of Marshall (arrow).

Video Supplement to "Recanalized Vein of Marshall Following Bidirectional Glenn Surgery" (October 2023 Clinical Image)

A 6-year-old boy with a case of double outlet right ventricle with large non-routable ventricle septaldefect and severe pulmonary stenosis was deemed unsuitable for biventricular repair on a priorevaluation. Hence, a bidirectional Glenn (BDG) shunt was performed at 3 years of age followingcardiac catheterization. He presented this time with worsening cyanosis and exertionalbreathlessness. The saturation was 88% at room air and the cardiac catheterization was performedbefore the total cavopulmonary connection (TCPC, Fontan) operation. The mean pulmonary artery(PA) pressure was 14 mmHg while the left ventricular end-diastolic pressure was 10 mmHg. Theventricular angiogram revealed normal contractility and moderate atrioventricular valve regurgitationbesides showing a generous antegrade flow in the pulmonary arteries.

© 2023 HMP Global. All Rights Reserved.
Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of The Journal of Invasive Cardiology or HMP Global, their employees, and affiliates. 

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