Nishikawa Y, Yamaguchi M, Hosokawa Y, Ohashi H, Oshima Y
Nihon Kyobu Geka Gakkai Zasshi. 1989 Nov;37(11):2429-33.
A surgical case of 8-year-old boy with scimitar syndrome is presented. The patient was admitted to the hospital because of exertional dyspnea and underdevelopment. Cardiac catheterization revealed a large amount of left to right shunt and O2 step up at the level of the inferior vena cava below the diaphragm. Angiography showed that the pulmonary vein draining the right lower lobe pierced the diaphragm and emptied into IVC. At operation the right pleural cavity was entered and a large anomalous pulmonary vein trunk was found which headed downward and medially and eventually entered in the diaphragm. A direct anastomosis between the scimitar vein and left atrium was made. To avoid kinking or stenosis of this vein, the parenchyma of the right lung (S7) was divided to create a passway of the vein. Anastomosis was performed without excessive tension or kinking on it. We conclude that the method applied in this case might be a procedure of choice for the repair of scimitar syndrome especially when there is no associating atrial septal defect or scimitar vein drains into IVC at the level lower than hepatic vein.
本文介绍了一例8岁患有弯刀综合征男孩的外科病例。该患者因劳力性呼吸困难和发育不全入院。心导管检查显示大量左向右分流，且在膈肌下方的下腔静脉水平处氧分压升高。血管造影显示，引流右下叶的肺静脉穿过膈肌并汇入下腔静脉。手术时进入右侧胸腔，发现一条粗大的异常肺静脉干，其向下内侧走行，最终进入膈肌。将弯刀状静脉与左心房进行直接吻合。为避免该静脉扭结或狭窄，将右肺实质（S7）分开以形成静脉通道。吻合术在无过度张力或扭结的情况下进行。我们得出结论，该病例所应用的方法可能是修复弯刀综合征的一种首选术式，尤其是在不存在相关房间隔缺损或弯刀状静脉汇入低于肝静脉水平的下腔静脉时。
