Iatrogenic Post-Surgical Cyanosis Due to Vena Caval Redirection to the Left Atrium and Its Transcatheter Management

During surgery for oval fossa defects, inadvertent suturing of pericardial patches to a prominent Eustachian valve diverts the inferior vena caval blood to the left atrium causing iatrogenic cyanosis. A similar complication may arise after surgery for superior sinus venosus defects. Surgical patch in a wrong plane may direct the superior vena cava towards the left atrium. Early post-operative diagnosis leads to immediate correction. Diagnosis delayed beyond many years lead to chronic hypoxemia and secondary polycythemia. This report details the clinical presentation and imaging of this iatrogenic complication in three patients and explains a transcatheter corrective intervention.