Kim Young Nam, Cho Hwa Jin, Cho Young Kuk, Ma Jae Sook
Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
Korean J Pediatr. 2012 Jan;55(1):24-8. doi: 10.3345/kjp.2012.55.1.24. Epub 2012 Jan 31.
Partial anomalous pulmonary vein connection (PAPVC) is a rare congenital abnormal cardiac defect involving the pulmonary veins draining into the right atrium (RA) directly or indirectly by venous connection. Ninety percent of PAPVCs are accompanied by atrial septal defect (ASD). To our knowledge, there is no previous report of PAPVC with ventricular septal defect (VSD) without ASD in Korea, and in this paper, we report the first such case. A 2-day-old girl was admitted into the Chonnam National University Hospital for evaluation of a cardiac murmur. An echocardiogram revealed perimembranous VSD without ASD. She underwent patch closure of the VSD at 5 months of age. Although the VSD was completely closed, she had persistent cardiomegaly with right ventricular volume overload, as revealed by echocardiography. Three years later, cardiac catheterization and chest computed tomography revealed a PAPVC, with the right upper pulmonary vein draining into the right SVC. Therefore, correction of the PAPVC was surgically performed at 3 years of age. We conclude that it is important to suspect PAPVC in patients with right ventricular volume overload, but without ASD.
部分性肺静脉异位连接(PAPVC)是一种罕见的先天性心脏缺陷,涉及肺静脉通过静脉连接直接或间接引流至右心房(RA)。90%的PAPVC伴有房间隔缺损(ASD)。据我们所知,韩国此前尚无无ASD的PAPVC合并室间隔缺损(VSD)的报道,本文报告首例此类病例。一名2日龄女童因心脏杂音入院全南国立大学医院评估。超声心动图显示为膜周部VSD,无ASD。她在5个月大时接受了VSD修补术。尽管VSD完全闭合,但超声心动图显示她仍有持续的心脏扩大及右心室容量超负荷。3年后,心导管检查和胸部计算机断层扫描显示存在PAPVC,右上肺静脉引流至右头臂静脉。因此,在3岁时对PAPVC进行了手术矫正。我们得出结论,对于右心室容量超负荷但无ASD的患者,怀疑PAPVC很重要。