Cardiology in the Young

Original Articles

Veno-venous bridges: the forerunners of the sinus venosus defect

Ryan J. Buttsa1 c1, Andrew M. Creana2a3, Anthony M. Hlavaceka1, Diane E. Spicera4a5, Andrew C. Cooka6, Erwin N. Oechslina2a3 and Robert H. Andersona1a6

a1 Department of Pediatric Cardiology, Medical University of South Carolina, Charleston, South Carolina, United States of America

a2 Division of Cardiology, Toronto Congenital Cardiac Centre for Adults, University Health Network, Toronto General Hospital, Toronto, Canada

a3 Department of Medical Imaging, Peter Munk Cardiac Centre, University Health Network, Toronto General Hospital, Toronto, Canada

a4 Department of Pediatrics, Division of Pediatric Cardiology, University of Florida, Gainesville, Flordia, United States of America

a5 The Congenital Heart Institute of Florida, St. Petersburg, Flordia, United States of America

a6 Cardiac Unit, Institute of Child Health, University College, London, United Kingdom

Abstract

Background Differentiation of the so-called sinus venosus defect from other defects permitting shunting between the atrial chambers remains problematic. The lesion is not a true septal defect, and current theories to explain the existence of the sinus venosus defect fall short. The presence of persistent systemic to pulmonary venous connections has been proposed to explain the existence of the sinus venosus defect.

Methods Clinical histories and radiological findings of six patients are reviewed. Three patients have veno-venous bridges, two have partial anomalous pulmonary venous connections, and one patient has a sinus venosus defect. The clinical information is reviewed, along with current developmental and morphological considerations.

Discussion We provide radiographic, developmental, and morphological evidence to support the theory that a so-called sinus venosus defect is the consequence of persistence of foetal systemic to pulmonary veno-venous bridges, rather than of deficiencies in atrial septation.

(Received September 17 2010)

(Accepted March 31 2011)

(Online publication May 24 2011)

Correspondence:

c1 Correspondence to: Dr R. Butts, Department of Pediatrics, Medical University of South Carolina, 171 Ashley Avenue, Charleston, South Carolina 29425, United States of America. Tel: 843 792 3286; Fax: 843 792 3284; E-mail: butts@musc.edu