Kubota Sayaka, Nakano Kiyoharu, Kodera Kojiro, Asano Ryota, Kataoka Go, Tatsuishi Wataru
Department of Cardiovascular Surgery, Tokyo Women's Medical University, Medical Center East, Nishiogu 2-1-10, Arakawa-Ku, Tokyo 116-8567, Japan.
Gen Thorac Cardiovasc Surg. 2012 Sep;60(9):569-71. doi: 10.1007/s11748-012-0001-y. Epub 2012 Jul 21.
Persistent left superior vena cava without a right superior vena cava is an extremely rare condition. We report the case of a 65-year-old woman with this condition who underwent mitral valve plasty. During cardiac catheterization, the asymptomatic patient with mitral valve prolapse syndrome was found to have a persistent left superior vena cava without a right superior vena cava. During mitral valve plasty, cardiopulmonary bypass was established using bicaval drainage through the persistent left superior vena cava and the right atrium. A cannula was inserted into the persistent left superior vena cava to provide a large surgical field in the left atrium. We selected a technique that involved direct insertion of an L-shaped cannula into the persistent left superior vena cava and obtained a clear view of the surgical field. Proper assessment of the right superior vena cava is necessary when a persistent left superior vena cava is suspected.
永存左上腔静脉而无右上腔静脉是一种极其罕见的情况。我们报告了一例患有这种情况的65岁女性接受二尖瓣成形术的病例。在心脏导管插入术中，发现这位患有二尖瓣脱垂综合征的无症状患者存在永存左上腔静脉而无右上腔静脉。在二尖瓣成形术中，通过经永存左上腔静脉和右心房进行双腔引流建立体外循环。将一根插管插入永存左上腔静脉以在左心房提供一个大的手术视野。我们选择了一种将L形插管直接插入永存左上腔静脉的技术，并获得了清晰的手术视野。当怀疑存在永存左上腔静脉时，对右上腔静脉进行适当评估是必要的。
