Transesophageal echocardiographic diagnosis of sinus venosus-type atrial septal defect associated with partial anomalous venous connections during cardiac surgery in adults

Abstract

T RANSESOPHAGEAL echocardiography (TEE) is useful for intraoperative monitoring of cardiac function 1,z and for evaluating valve repair. 3 Recently, TEE has been proposed as a useful intraoperative tool improving diagnostic accuracy and assisting in surgical repair of pediatric congenital heart malformations. 4 Its role in the diagnosis of congemtal cardiac malformations in adults has not been widely discussed. The sinus venosus variant of atrial septal defect (SVASD) occurs in up to 20% of adults with an atrial septal defect (ASD) and is the most difficult to Identify. 5 This defect is frequently associated with anomalous connection of the right pulmonary veins to the junction of the right atrium and the superior vena cava. 6 The authors describe two cases of adult cardmc surgery where intraoperative TEE helped to diagnose previously unsuspected SVASD associated with partial anomalous pulmonary venous connections (PAPVC) and discuss how the echocardiography results led to modification of the planned operation.