Case Report: Thoracoscopic repair of a residual inferior sinus venosus-type defect with right lower pulmonary vein–inferior vena cava communication: intraoperative support using real-time 3D transesophageal echocardiography

• DOI: 10.3389/fcvm.2025.1568703
• Publication Date: 2025-05-13T05:29:48Z
• Authors: Tianzong Li; Yiran Luo; Qin Liang; Kui Hu; Chao Wang
• Keywords: Sinus venosus

Background Residual venous defects after atrial septal defect (ASD) repair may remain asymptomatic for years and can be misinterpreted as partial anomalous pulmonary return. Accurate intraoperative imaging is essential to confirm the anatomy guide repair, particularly in minimally invasive surgery. Case presentation A 28-year-old woman with no cardiopulmonary symptoms was referred an abnormal electrocardiographic findings during a routine physical examination. She had undergone ASD at age 3. Transthoracic echocardiography revealed right heart enlargement, severe tricuspid regurgitation, suspected communication between lower vein (RLPV) inferior vena cava (IVC), later confirmed by cardiac CT. underwent thoracoscopic annuloplasty. Real-time 3D transesophageal (RT-3D TEE) used aid location of residual RLPV–IVC communication, support placement guidewire catheter, assist post-repair assessment. The surgery completed successfully complications, follow-up showed complete resolution defect. Conclusion In this case, RT-3D TEE provided effective enhancing spatial orientation improving procedural confidence. While not all cases, it serve valuable assistant anatomically complex or visually limited situations.