Document Type


Publication Date

Spring 5-2004


Atrial septal defects (ASDs) are a common congenital abnormality, and operative repair is a routine, safe procedure. Diversion of the inferior vena cava (IVC) into the left atrium is an unusual complication following ASD closure. We report a case that illustrates the problem created by this right-to-left shunt. A middle-aged woman underwent ASD repair. She developed hypoxemia postoperatively. A transthoracic echocardiogram confirmed a right-to-left shunt, found only with agitated saline injected into the femoral vein, not into the basilic vein. Surgical reexploration revealed a residual ASD diverting IVC flow into the left atrium, which was repaired with a pericardial patch. Echocardiography with agitated saline injected from the femoral vein is an easy method to diagnose this uncommon complication.


This is the pre-peer reviewed version of the following article: Thompson, E., Moritz, D., Perdue, R., & Cansino, S. (2004). Diversion of the inferior vena cava following repair of atrial septal defect causing hypoxemia. Echocardiography, 21(4), 329-332, which has been published in final form at Copyright © 2004, John Wiley & Sons. All rights reserved. The published version is available through PubMed at

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