Ugaki Shinya, Kasahara Shingo, Fujii Yasuhiro, Sano Shunji
Department of Cardiovascular Surgery, Okayama University Hospital, 2-5-1 Shikata, Okayama City, Okayama 700-8558, Japan.
Interact Cardiovasc Thorac Surg. 2010 Aug;11(2):199-201. doi: 10.1510/icvts.2009.230581. Epub 2010 May 3.
The anatomy of a persistent left superior vena cava (SVC) to the left atrium (LA) without the innominate vein can make it challenging to complete intracardiac repair. We reviewed our five cases of the direct end-to-side anastomosis of SVCs to facilitate anatomical repair of SVC-right atrial connection for biventricular repair. Diagnoses were two partial atrioventricular septal defect with left isomerism, one complete atrioventricular septal defect (CAVSD) with left isomerism, one CAVSD without isomerism and one atrioventricular discordance and double outlet right ventricle with right isomerism. Mean age at the operation was 20+/-23 months (4-58 months) and body weight was 7.8+/-3.4 kg (4.8-12.7 kg). After completion of intracardiac repair, the SVC to LA was divided and end-to-side anastomosed to the SVC to the right atrium during cardiopulmonary bypass. No early or late death occurred during follow-up of 14.4+/-6.9 months (7-23 months). None of the patients developed an obstruction at the anastomosis site of the SVCs. The direct end-to-side anastomosis of SVCs achieved an excellent anatomical SVC-right atrium connection in complex congenital heart diseases.
存在一条持续左上腔静脉（SVC）直接连接至左心房（LA）且无无名静脉的解剖结构，会给心内修复带来挑战。我们回顾了5例通过直接端侧吻合SVC来促进SVC - 右心房连接的解剖修复以进行双心室修复的病例。诊断包括2例合并左心异构的部分房室间隔缺损、1例合并左心异构的完全性房室间隔缺损（CAVSD）、1例无异构的CAVSD以及1例合并右心异构的房室不一致和右心室双出口。手术时的平均年龄为20±23个月（4 - 58个月），体重为7.8±3.4千克（4.8 - 12.7千克）。在心内修复完成后，在体外循环期间将连接至左心房的SVC切断，并与连接至右心房的SVC进行端侧吻合。在14.4±6.9个月（7 - 23个月）的随访期间未发生早期或晚期死亡。所有患者在SVC吻合部位均未出现梗阻。在复杂先天性心脏病中，SVC的直接端侧吻合实现了出色的SVC - 右心房解剖连接。
