Emmoto T, Wada Y, Kawai T, Nishiyama K, Oga K, Oka T
Second Department of Surgery, Kyoto Prefectural University of Medicine.
Kyobu Geka. 1991 Nov;44(12):1052-5.
A successfully treated case of one-year-old girl of common atrium associated with bilateral superior vena cava and an interrupted inferior vena cava with hemiazygos continuation is reported. In addition to these anomalies of systemic venous connection, both atrial appendages show morphological characteristics of left type, and the final diagnosis of left atrial isomerism was made. In the corrective surgery, atrial septation was reconstructed using trimmed autogenous pericardial patch to allow the left superior vena cava to drain into the right side of the common atrium. The patient had been pointed out bradycardia (50-100/min) since her birth. Postoperative electrocardiogram also showed bradycardia (78-100/min). Especially in sleeping, her heart rate was 50-60/min, resulting in A-V junctional escaped rhythm and A-V dissociation. This fact suggests that her sinus node is absent or hypoplastic, one of the characteristics of left atrial isomerism. Since left atrial isomerism is reported to cause a decrease of atrial rhythm with aging, careful postoperative observation on specific arrhythmia is necessary.
报道了一例成功治疗的一岁女童病例，其患有共同心房合并双侧上腔静脉及下腔静脉中断伴半奇静脉延续。除了这些体静脉连接异常外，两个心耳均显示出左型形态特征，最终诊断为左心房异构。在矫正手术中，使用修剪后的自体心包补片重建房间隔，以使左上腔静脉引流至共同心房右侧。该患者自出生以来就存在心动过缓（50 - 100次/分钟）。术后心电图也显示心动过缓（78 - 100次/分钟）。特别是在睡眠时，她的心率为50 - 60次/分钟，导致房室交界性逸搏心律和房室分离。这一事实表明她的窦房结缺失或发育不全，这是左心房异构的特征之一。由于据报道左心房异构会随着年龄增长导致心房节律减慢，因此术后对特定心律失常进行仔细观察是必要的。
