Toda S, Wada Y, Kawai T, Nishiyama K, Oga K, Oka T
Nihon Kyobu Geka Gakkai Zasshi. 1989 Sep;37(9):2041-5.
A successful repair of total left anomalous pulmonary venous return with intact atrial septum is reported. A 7-year-old girl was admitted for evaluation of cardiac murmur which was first noted at 3 months of age. She had been followed up on suspicion of ASD, without any subjective symptoms. Physical examination on admission revealed a systolic ejection murmur at left sternal border. Chest X-ray showed mild cardiomegaly and increased pulmonary vascularity. ECG showed right axis deviation and incomplete right bundle branch block. Selective pulmonary arteriography delineated anomalous return of all left pulmonary veins to RA via vertical vein, left brachiocephalic vein, and SVC, and documented the absence of an atrial septal defect. Ratio of pulmonary to systemic blood flow was 2.2. Vertical vein was anastomosed to left atrial appendage under cardiopulmonary bypass. Postoperative cardiac catheterization showed no difference of wedge pressure between bilateral PA. The patient is up and well 1 years and 6 months after operation.
报道了一例房间隔完整的完全性左肺静脉异位引流的成功修复病例。一名7岁女孩因心脏杂音入院评估，该杂音于3个月大时首次被发现。她因疑似房间隔缺损而接受随访，无任何主观症状。入院时体格检查发现左胸骨缘有收缩期喷射性杂音。胸部X线显示轻度心脏扩大和肺血管增多。心电图显示电轴右偏和不完全性右束支传导阻滞。选择性肺动脉造影显示所有左肺静脉通过垂直静脉、左头臂静脉和上腔静脉异常回流至右心房，并证实无房间隔缺损。肺循环与体循环血流量之比为2.2。在体外循环下将垂直静脉与左心耳吻合。术后心脏导管检查显示双侧肺动脉楔压无差异。患者术后1年6个月情况良好，已康复。
