LATE DETECTION OF INFERIOR VENA-CAVA DRAI NING INTO THE LEFT ATRIUM AFTER SURGICAL CLOSURE OF ATRIAL SEPTAL-DEFECT

Drainage of the inferior vena cava into the left atrium during surgery for closure of an atrial septal defect is a rare complication. More c ommon in low situated defects, it was more frequent when this type of surgery was performed without cardiopulmonary bypass. This diagnosis w as made in a 45 year old woman with cyanosis operated 28 years previou sly. The right-to-left shunt was demonstrated by the hyperoxia test an d confirmed by perfusion pulmonary scintigraphy and contrast echocardi ography but only when the contrast was injected in the inferior vena c ava territory, and by angiography. The surgeon confirmed the abnormali ty, closed the interatrial septum and reconnected the inferior vena ca va to the right atrium.