经主动脉后植入修复持续左上腔静脉至无顶冠状静脉窦缺损（改良沃登型手术）
Repair of Persistent Left Superior Vena Cava to Unroofed Coronary Sinus Defect by Retro-Aortic Implantation (Modified Warden Type Procedure).
作者信息
Muthialu Nagarajan, Fajardo Diana, Sullivan Ian D, Tsang Victor
机构信息
Department of Cardiothoracic Surgery, Great Ormond Street Hospital, Great Ormond Street, London, United Kingdom.
Department of Cardiology, Great Ormond Street Hospital, Great Ormond Street, London, United Kingdom.
出版信息
J Card Surg. 2016 Feb;31(2):103-5. doi: 10.1111/jocs.12684. Epub 2016 Jan 7.
BACKGROUND
Repair of unroofed coronary sinus defect in the presence of left superior vena cava is challenging and requires prosthetic graft material to redirect flow to the right atrium. This may potentially cause a supra-mitral gradient or pulmonary venous obstruction.
METHODS
Three patients with unroofed coronary sinus in the presence of a left superior vena cava (LSVC) underwent modified cavo-atrial anastomosis (Warden technique) to achieve reimplantation of the LSVC in a retro-aortic fashion to the right atrial appendage.
RESULTS
Three patients recovered well with no evidence of an intracardiac shunt. Postoperative echocardiography demonstrated normal venous flows in the LSVC.
CONCLUSION
This modified technique offers correction of this systemic venous anomaly without the need for any additional graft material.
背景
在存在左上腔静脉的情况下修复冠状静脉窦未闭缺损具有挑战性，需要人工移植物材料将血流改道至右心房。这可能会潜在地导致二尖瓣上梯度或肺静脉梗阻。
方法
3例存在左上腔静脉（LSVC）的冠状静脉窦未闭患者接受了改良腔房吻合术（沃登技术），以逆行主动脉方式将LSVC重新植入右心耳。
结果
3例患者恢复良好，无心脏内分流证据。术后超声心动图显示LSVC内静脉血流正常。
结论
这种改良技术可纠正这种体静脉异常，无需任何额外的移植物材料。
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