Thoracic duct drainage patterns in heterotaxy
Background: Disordered lymphatic drainage is common in congenital heart diseases (CHD), but thoracic duct (TD) drainage patterns in heterotaxy have not been described in detail. This study sought to describe terminal TD sidedness in heterotaxy and its associations with other anatomic variables. Meth...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-01-01
|
| Series: | Journal of Cardiovascular Magnetic Resonance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1097664724010779 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850065281165033472 |
|---|---|
| author | Daniel A. Castellanos Emily M. Bucholz Katherine Bai Jesse J. Esch David Hoganson Stephen P. Sanders Raja Shaikh Sunil J. Ghelani David N. Schidlow |
| author_facet | Daniel A. Castellanos Emily M. Bucholz Katherine Bai Jesse J. Esch David Hoganson Stephen P. Sanders Raja Shaikh Sunil J. Ghelani David N. Schidlow |
| author_sort | Daniel A. Castellanos |
| collection | DOAJ |
| description | Background: Disordered lymphatic drainage is common in congenital heart diseases (CHD), but thoracic duct (TD) drainage patterns in heterotaxy have not been described in detail. This study sought to describe terminal TD sidedness in heterotaxy and its associations with other anatomic variables. Methods: This was a retrospective, single-center study of patients with heterotaxy who underwent cardiovascular magnetic resonance imaging at a single center between July 1, 2019 and May 15, 2023. Patients with (1) asplenia (right isomerism), (2) polysplenia (left isomerism) and (3) pulmonary/abdominal situs inversus (PASI) plus CHD were included. Terminal TD sidedness was described as left-sided, right-sided, or bilateral. Results: Of 115 eligible patients, the terminal TD was visualized in 56 (49 %). The terminal TD was left-sided in 25 patients, right-sided in 29, and bilateral in two. On univariate analysis, terminal TD sidedness was associated with atrial situs (p = 0.006), abdominal situs (p = 0.042), type of heterotaxy (p = 0.036), the presence of pulmonary obstruction (p = 0.041), superior vena cava sidedness (p = 0.005), and arch sidedness (p < 0.001). On multivariable analysis, only superior vena cava and aortic arch sidedness were independently associated with terminal TD sidedness. Conclusions: Terminal TD sidedness is highly variable in patients with heterotaxy. Superior vena cava and arch sidedness are independently associated with terminal TD sidedness. Type of heterotaxy was not independently associated with terminal TD sidedness. This data improves the understanding of anatomic variation in patients with heterotaxy and may be useful for planning for lymphatic interventions. |
| format | Article |
| id | doaj-art-508f00a8e7654494ba0a2e372631b442 |
| institution | DOAJ |
| issn | 1097-6647 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj-art-508f00a8e7654494ba0a2e372631b4422025-08-20T02:49:02ZengElsevierJournal of Cardiovascular Magnetic Resonance1097-66472024-01-0126210105010.1016/j.jocmr.2024.101050Thoracic duct drainage patterns in heterotaxyDaniel A. Castellanos0Emily M. Bucholz1Katherine Bai2Jesse J. Esch3David Hoganson4Stephen P. Sanders5Raja Shaikh6Sunil J. Ghelani7David N. Schidlow8Department of Cardiology, Boston Children's Hospital, Boston, MA, United States; Department of Pediatrics, Harvard Medical School, Boston, MA, United States; Correspondance to: 300 Longwood Avenue, BCH 3215, Boston, MA, 02115.Children’s Hospital Colorado and the University of Colorado, Denver, CO, United StatesDepartment of Cardiology, Boston Children's Hospital, Boston, MA, United StatesDepartment of Cardiology, Boston Children's Hospital, Boston, MA, United States; Department of Pediatrics, Harvard Medical School, Boston, MA, United StatesDepartment of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, United StatesDepartment of Pediatrics, Harvard Medical School, Boston, MA, United States; Cardiac Registry, Departments of Cardiology, Pathology, and Cardiac Surgery, Boston Children’s Hospital, Boston, MA, United StatesDepartment of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, MA, United StatesDepartment of Cardiology, Boston Children's Hospital, Boston, MA, United States; Department of Pediatrics, Harvard Medical School, Boston, MA, United StatesDepartment of Cardiology, Boston Children's Hospital, Boston, MA, United States; Department of Pediatrics, Harvard Medical School, Boston, MA, United StatesBackground: Disordered lymphatic drainage is common in congenital heart diseases (CHD), but thoracic duct (TD) drainage patterns in heterotaxy have not been described in detail. This study sought to describe terminal TD sidedness in heterotaxy and its associations with other anatomic variables. Methods: This was a retrospective, single-center study of patients with heterotaxy who underwent cardiovascular magnetic resonance imaging at a single center between July 1, 2019 and May 15, 2023. Patients with (1) asplenia (right isomerism), (2) polysplenia (left isomerism) and (3) pulmonary/abdominal situs inversus (PASI) plus CHD were included. Terminal TD sidedness was described as left-sided, right-sided, or bilateral. Results: Of 115 eligible patients, the terminal TD was visualized in 56 (49 %). The terminal TD was left-sided in 25 patients, right-sided in 29, and bilateral in two. On univariate analysis, terminal TD sidedness was associated with atrial situs (p = 0.006), abdominal situs (p = 0.042), type of heterotaxy (p = 0.036), the presence of pulmonary obstruction (p = 0.041), superior vena cava sidedness (p = 0.005), and arch sidedness (p < 0.001). On multivariable analysis, only superior vena cava and aortic arch sidedness were independently associated with terminal TD sidedness. Conclusions: Terminal TD sidedness is highly variable in patients with heterotaxy. Superior vena cava and arch sidedness are independently associated with terminal TD sidedness. Type of heterotaxy was not independently associated with terminal TD sidedness. This data improves the understanding of anatomic variation in patients with heterotaxy and may be useful for planning for lymphatic interventions.http://www.sciencedirect.com/science/article/pii/S1097664724010779Thoracic ductLymphaticHeterotaxyCongenital heart diseaseCardiovascular magnetic resonance imaging |
| spellingShingle | Daniel A. Castellanos Emily M. Bucholz Katherine Bai Jesse J. Esch David Hoganson Stephen P. Sanders Raja Shaikh Sunil J. Ghelani David N. Schidlow Thoracic duct drainage patterns in heterotaxy Journal of Cardiovascular Magnetic Resonance Thoracic duct Lymphatic Heterotaxy Congenital heart disease Cardiovascular magnetic resonance imaging |
| title | Thoracic duct drainage patterns in heterotaxy |
| title_full | Thoracic duct drainage patterns in heterotaxy |
| title_fullStr | Thoracic duct drainage patterns in heterotaxy |
| title_full_unstemmed | Thoracic duct drainage patterns in heterotaxy |
| title_short | Thoracic duct drainage patterns in heterotaxy |
| title_sort | thoracic duct drainage patterns in heterotaxy |
| topic | Thoracic duct Lymphatic Heterotaxy Congenital heart disease Cardiovascular magnetic resonance imaging |
| url | http://www.sciencedirect.com/science/article/pii/S1097664724010779 |
| work_keys_str_mv | AT danielacastellanos thoracicductdrainagepatternsinheterotaxy AT emilymbucholz thoracicductdrainagepatternsinheterotaxy AT katherinebai thoracicductdrainagepatternsinheterotaxy AT jessejesch thoracicductdrainagepatternsinheterotaxy AT davidhoganson thoracicductdrainagepatternsinheterotaxy AT stephenpsanders thoracicductdrainagepatternsinheterotaxy AT rajashaikh thoracicductdrainagepatternsinheterotaxy AT suniljghelani thoracicductdrainagepatternsinheterotaxy AT davidnschidlow thoracicductdrainagepatternsinheterotaxy |