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Am J Perinatol 2006; 23(3): 181-182
DOI: 10.1055/s-2006-934096
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Persistent Right Umbilical Vein Associated with Complex Congenital Cardiac Malformation

Thomas Hoehn1 , Michael Lueder2 , Klaus G. Schmidt3 , Joerg Schaper4 , Ertan Mayatepek1
  • 1Neonatology and Pediatric Intensive Care Medicine, Department of General Pediatrics, Heinrich-Heine-University, Duesseldorf, Germany
  • 2Evangelisches Krankenhaus Duesseldorf, Duesseldorf, Germany
  • 3Department of Pediatric Cardiology, Heinrich-Heine-University, Duesseldorf, Germany
  • 4Department of Pediatric Radiology, Heinrich-Heine-University, Duesseldorf, Germany
Further Information

Publication History

Publication Date:
29 March 2006 (online)

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ABSTRACT

Umbilical venous catheterization is frequently used for vascular access during neonatal resuscitation. The differentiation between umbilical artery and vein, specifically during the resuscitation procedure, is clinically neither always easy nor unambiguous. A preterm infant of 35 weeks of gestational age was born after an uneventful course of his mother's pregnancy. Severe postnatal cyanosis led to the placement of presumed arterial and venous umbilical catheters. Chest x-ray was suggestive of the presence of a persistent right umbilical vein (PRUV). Echocardiography showed a double outlet right ventricle with mitral atresia and a levo-atrial cardinal vein draining the left atrium into the azygos vein. The foramen ovale was firmly closed and conventional balloon atrioseptostomy failed. Several attempts of transseptal puncture and subsequent creation of an atrial septal defect were unsuccessful and the infant eventually died. There is an association of PRUV and congenital cardiac malformation. PRUV can be diagnosed prenatally if specifically looked for. The presence of PRUV can be the only clue prenatally alerting to the presence of congenital heart disease. Postnatal diagnosis of PRUV may justify echocardiography and cardiologic assessment even in the absence of clinical cyanosis.

KEYWORDS

Congenital heart disease - umbilical catheter - newborn infant - persistent right umbilical vein

REFERENCES

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Thomas HoehnM.D. Ph.D. 

Neonatology and Pediatric Intensive Care Medicine, Department of General Pediatrics, Heinrich-Heine-University, Moorenstr

5, D-40225 Duesseldorf, Germany

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