What Happens If Hepatic Veins Drain to the Pulmonary Venous Atrium?: Depends on the Physiology!

Kali A Hopkins; Barry A Love

doi:10.1016/j.jaccas.2025.103305

What Happens If Hepatic Veins Drain to the Pulmonary Venous Atrium?: Depends on the Physiology!

JACC Case Rep. 2025 May 21;30(11):103305. doi: 10.1016/j.jaccas.2025.103305. Epub 2025 Mar 12.

Authors

Kali A Hopkins¹, Barry A Love²

Affiliations

¹ Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, New York, USA; Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address: Kali.hopkins@mountsinai.org.
² Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, New York, USA; Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Abstract

In rare instances in congenital cardiac surgery, ≥1 of the hepatic veins may end up incorporated either intentionally or inadvertently with the pulmonary venous atrium (oxygenated blood) while the remainder of the hepatic veins are left to drain normally with the systemic venous blood (less oxygenated blood). What happens when this is done? As it turns out, hepatic venous connections end up forming between the lobes of the liver, and a significant shunt results. The direction of shunting, however, depends on the physiology. We present 2 cases in which a single hepatic vein was left connected to the pulmonary venous atrium and produced very different hemodynamic consequences.

Keywords: atrial septal defect; congenital heart defect; occlude.

Publication types

Case Reports