Korean J Thorac Cardiovasc Surg.  1997 May;30(5):493-500.

Hepatic Venous Return in Atrial Isomerism Evaluated by MR

  • 1Department of Diagnostic Radiology, Yonsei University, College of Medicine, Korea.
  • 2Department Cardiovascular Surgery, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Korea.
  • 3Pediatric Cardiology of Cardiovascular Center, Yonsei University, College of medicine, Korea.


We performed this study to evaluate hepatic venous drainage in atrial isomerism by MR and the clinical significance of anomalous hepatic venous return in total cavopulmonary shunt operation. Numbers and locations of hepatic veins in twenty-two patients with isomerism(thirteen with right isomerism and nine with left isomerism) were evaluated by MR. Operative procedure of hepatic veins and postoperative arterial oxygen saturation were compared with hepatic vein connection in six patients after total cavopulmonary shunt operation. Among nine patients with left isomerism, hepatic venous return was totally anomalous via a single opening in eight, and via two separate openings in one. Among thirteen patients with right isomerism, partial anomalous hepatic venous connection directly to the atrium was seen in four. One showed total anomalous hepatic venous connection to atrium through one opening. Total cavopulmonary shunt operation was performed in 6 patients. Hepatic veins were connected to pulmonary arteries in four patients who had one atrial opening of hepatic vein and/or IVC, or two ipsilateral atrial opening of hepatic veins and IVC. In conclusion, hepatic vein drainage to atrium is variable in atrial isomerism. MR is useful for evaluation of hepatic vein drainage in atrial isomerism and surgical planning.


Heart defect, congenital; Magnetic resonance imaging; Systemic vein; Systemic-pulmonary arterial anastomosis

MeSH Terms

Heart Bypass, Right
Heart Defects, Congenital
Hepatic Veins
Magnetic Resonance Imaging
Pulmonary Artery
Surgical Procedures, Operative
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