Watanabe M, Aoki M, Fujiwara T
Department of Cardiovascular Surgery, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Japan.
Kyobu Geka. 2008 Aug;61(9):803-7.
A 3-year-old girl with polysplenia, atrial septal defect (ASD), and partial anomalous pulmonary venous connection (PAPVC) was admitted to our unit to have total correction. Preoperative three-dimensional computed tomography (3D-CT) and transesophageal echo (TEE) showed that the pulmonary veins were connected with what normally constitutes the posterior wall of the left atrium, but right pulmonary veins became incorporated into the right atrium because of the atrial septal displacement. In the procedure, intracardiac inspection revealed absence of septum secondum and leftward deviation of septum primum. Deviated septum primum was incised at the posterior edge and shifted rightward to incorporate right pulmonary veins into the left atrium. ASD was closed using autologous pericardial patch. This type of PAPVC was rare and preoperative 3D-CT and TEE was quite useful in evaluating unique anatomical characteristics.
一名患有多脾畸形、房间隔缺损（ASD）和部分肺静脉异位连接（PAPVC）的3岁女孩入住我院接受根治手术。术前三维计算机断层扫描（3D-CT）和经食管超声心动图（TEE）显示，肺静脉与正常构成左心房后壁的结构相连，但由于房间隔移位，右肺静脉并入了右心房。手术中，心脏内检查发现继发隔缺失，原发隔向左偏移。在原发隔的后缘切开并向右移位，将右肺静脉纳入左心房。使用自体心包补片封闭房间隔缺损。这种类型的PAPVC很罕见，术前3D-CT和TEE在评估独特的解剖特征方面非常有用。
