Common Atrium With Cleft AML and Left Superior Vena Cava Draining Into Left Atrium and Midline Inferior Vena Cava

A 3-year-old boy presented with a history of cyanosis and recurrent lower respiratory tract infections since birth. He had a resting saturation between 80-90% and was diagnosed as common atrium with severe mitral valve regurgitation and cleft in the anterior mitral leaflet (AML). During surgery, the presence of a midline inferior vena cava and left superior vena cava draining into the morphologic left atrium below the atrial appendage was an intraoperative surprise. Although it was difficult, the authors were able to reroute the LSVC and IVC to the right atrium without producing any obstruction to the systemic or pulmonary veins, and the bi-atrial size was normal after repair. The cleft in the AML was closed with interrupted inverting sutures, and the child had only trivial mitral regurgitation after repair. He had a mild lower respiratory tract infection in the postoperative period; otherwise he recovered well and was discharged on seventh postoperative day. The take-home message is that common at atrium is a rare condition with few case reports (1), and there is paucity of literature and videos of corrective surgery of common atrium to the best of the authors’ knowledge.

Reference

1. Zhang Y, Yang ZG, Yang MX, Shi K, Li R, Diao K-Y, et al. Common atrium and the associated malformations: Evaluation by low-dose dual-source computed tomography. Medicine (Baltimore). 2018;97(46):e12983.

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