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Heart, Lung and Circulation
Clinical Spotlight| Volume 19, ISSUE 10, P615-619, October 2010

Sinus Venosus Atrial Septal Defect in Adults: Utility of Cardiovascular MRI in resolving this Diagnostic Dilemma

      Sinus venosus atrial septal defect (SV-ASD) can be a challenging diagnostic problem. It can present with non-specific signs and symptoms and, on imaging, can mimic other causes of right heart dilatation. Transthoracic echocardiography using standard scan planes may be limited, due to the defect and any associated anomalous pulmonary venous drainage lying outside the confines of the fossa ovalis. At our institution, we use cardiovascular magnetic resonance imaging (CMRI) as a problem-solving tool in these patients. In this article, we discuss the utility of CMRI in establishing the diagnosis by presenting our recent experience and illustrating it with sample cases. We wish to highlight the problems relating to making a diagnosis of SV-ASD in adult patients, and how CMRI has contributed to overcoming these in our practice.

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      References

        • Webb G.
        • Gatzoulis M.A.
        Atrial septal defects in the adult: recent progress and overview.
        Circulation. 2006; 114: 1645-1653
        • Davia J.E.
        • Cheitlin M.D.
        • Bedynek J.L.
        Sinus venosus atrial septal defect.
        Am Heart J. 1973; 85: 177-185
        • Oliver J.M.
        • Gallego P.
        • Gonzalez A.
        • Dominguez F.J.
        • Aroca A.
        • Mesa J.M.
        Sinus venosus syndrome: atrial septal defect or anomalous venous connection? A multiplane transoesophageal approach.
        Heart. 2002; 88: 634-638
        • Gaca A.M.
        • Jaggers J.J.
        • Dudley L.T.
        • Bisset G.S.
        Repair of congenital heart disease: a primer-part 1.
        Radiology. 2008; 247: 617-631
        • Vogel M.
        • Berger F.
        • Kramer A.
        • Alexi-Meshkishvili V.
        • Lange P.E.
        Incidence of secondary pulmonary hypertension in adults with atrial septal or sinus venosus defects.
        Heart. 1999; 82 (30–33.5)
        • Brickner M.E.
        • Hillis L.D.
        • Lange R.A.
        Congenital heart disease in adults- first of two parts.
        N Engl J Med. 2000; 342: 256-263
        • Murphy J.G.
        • Gersh B.J.
        • McGoon M.D.
        • Mair D.D.
        • Porter C.J.
        • Ilstrup D.M.
        • McGoon D.C.
        • Puga F.J.
        • Kirklin J.W.
        • Danielson G.K.
        Long-term outcome after surgical repair of isolated atrial septal defect: follow-up at 27 to 32 years.
        N Engl J Med. 1990; 323: 1645-1650
        • Pascoe R.D.
        • Oh J.K.
        • Warnes C.A.
        • Danielson G.K.
        • Tajik A.J.
        • Seward J.B.
        Diagnosis of sinus venosus atrial septal defect with transesophageal echocardiography.
        Circulation. 1996; 94: 1049-1055
        • Ferrari V.A.
        • Scott C.H.
        • Holland G.A.
        • Axel L.
        • Sutton M.S.
        Ultrafast three-dimensional contrast enhanced magnetic resonance angiography and imaging in the diagnosis of partial anomalous pulmonary venous drainage.
        J Am Coll Cardiol. 2001; 37: 1120-1128
        • Valente A.M.
        • Sena L.
        • Powell A.J.
        • Del Nido P.J.
        • Geva T.
        Cardiac magnetic resonance imaging evaluation of sinus venosus defects: comparison to surgical findings.
        Pediatr Cardiol. 2007; 28: 51-56
        • Haramati L.B.
        • Moche I.E.
        • Rivera V.T.
        • Patel P.V.
        • Heyneman L.
        • McAdams H.P.
        • Issenberg H.J.
        • White C.S.
        Computed tomography of partial anomalous pulmonary venous connection in adults.
        J Comput Assist Tomogr. 2003; 27: 743-749
        • Mohrs O.K.
        • Petersen S.E.
        • Erkapic D.
        • Victor A.
        • Schlosser T.
        • Nowak B.
        • Kauffmann G.
        • Voigtlaender T.
        • Kauczor H.U.
        Dynamic contrast-enhanced MRI before and after transcatheter occlusion of patent foramen ovale.
        AJR Am J Roentgenol. 2007; 188: 844-849
        • Pennell D.J.
        • Sechtem U.P.
        • Higgins C.B.
        • Manning W.J.
        • Pohost G.M.
        • Rademakers F.E.
        • van Rossum A.C.
        • Shaw L.J.
        • Yucel EK
        Clinical indications for cardiovascular magnetic resonance (CMR): consensus panel report.
        J Cardiovasc Magn Reson. 2004; 6: 727-765
        • Arheden H.
        • Holmqvist C.
        • Thilen U.
        • Hanséus K.
        • Björkhem G.
        • Pahlm O.
        • Laurin S.
        • Ståhlberg F.
        Left-to-right cardiac shunts: comparison of measurements obtained with MR velocity mapping and with radionuclide angiography.
        Radiology. 1999; 211: 453-458
        • Kafka H.
        • Mohiaddin R.H.
        Cardiac MRI and pulmonary MR angiography of sinus venosus defect and partial anomalous pulmonary venous connection in cause of right undiagnosed ventricular enlargement.
        AJR Am J Roentgenol. 2009; 192: 259-266