Alternate pathways to pulmonary venous flow in left sided obstructive anomalies

C. B. Beckman, J. H. Moller, J. E. Edwards

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

In cardiac anomalies causing severe obstruction in the left side of the heart, such as aortic atresia, mitral atresia, or occasionally severe aortic stenosis, maintenance of circulation depends upon shunting of pulmonary venous blood into the right atrium. The usual pathway by which the shunt is achieved is across the atrial septum through the foramen ovale. When this route is closed or severely narrowed, alternate but less common pathways may exist. These involve either anomalous connections of pulmonary veins to systemic veins or communications with the coronary venous system. In the latter, as commonly occurs in aortic atresia, left ventricular myocardial sinusoids carry pulmonary venous blood from the left ventricular cavity and into the cardiac veins. In other instances of severe left sided obstruction, a direct communication may exist between the left atrium and the coronary sinus.

Original languageEnglish (US)
Pages (from-to)509-516
Number of pages8
JournalCirculation
Volume52
Issue number3
DOIs
StatePublished - 1975

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