Marini Davide, Castagno Matteo, Millesimo Michele, Ferroni Francesca, Ferraro Gaetana, Pace Napoleone Carlo, Agnoletti Gabriella
Division of Pediatric Cardiology, Ospedale Infantile Regina Margherita, Citta' della Salute e della Scienza di Torino,Department of Public Health and Pediatrics,University of Turin,Turin,Italy.
Cardiol Young. 2017 Oct;27(8):1550-1556. doi: 10.1017/S1047951117000737. Epub 2017 May 8.
Data regarding long-term outcome after percutaneous closure of left superior caval vein draining into the left atrium are lacking. The aim of the present study was to report the long-term follow-up by using contrast-enhanced CT.
In all, three patients underwent percutaneous closure of left superior caval vein draining into the left atrium between 2005 and 2015. All of them were evaluated clinically and underwent contrast-enhanced CT.
In one patient, the Amplatzer® Septal Occluder was used. In two patients, the Amplatzer® Vascular Plug type-1 was preferred: the device size/LSVC diameter ratio was 1.7 in the child and 1.2 in the adult. There were no early-onset or long-term onset complications. CT was performed 1, 2, and 10 years after the procedure, respectively. Complete occlusion of the vessel was documented in all. After 10 years since the procedure, CT revealed a persistent trivial residual shunt through the accessory hemiazygos vein in one patient, in whom the device was implanted above its drainage into the left superior caval vein. When an Amplatzer® Vascular Plug type-1 is oversized compared with the venous vessel diameter, it immediately assumes a dog-bone shape that disappears early to regain its shape memory and nominal size.
Percutaneous occlusion of left superior caval vein draining into the left atrium has excellent early and long-term outcomes. The optimal implantation of the device is below the drainage of the accessory hemiazygos vein, when present. The device might be oversized compared with the left superior caval vein diameter according to the age of the patient.
目前缺乏关于经皮封堵引流至左心房的左上腔静脉后长期预后的数据。本研究的目的是报告使用对比增强CT进行的长期随访结果。
2005年至2015年间，共有3例患者接受了经皮封堵引流至左心房的左上腔静脉的治疗。所有患者均接受了临床评估并进行了对比增强CT检查。
1例患者使用了Amplatzer®房间隔封堵器。2例患者更倾向于使用Amplatzer®1型血管封堵器：儿童患者的封堵器尺寸与左上腔静脉直径之比为1.7，成人患者为1.2。未出现早期或长期并发症。分别在术后1年、2年和10年进行了CT检查。所有病例均记录到血管完全闭塞。术后10年，CT显示1例患者通过副半奇静脉存在持续性微量残余分流，该患者的封堵器植入位置高于其引流至左上腔静脉的部位。当Amplatzer®1型血管封堵器相对于静脉血管直径过大时，它会立即呈现狗骨形状，并在早期消失以恢复其形状记忆和标称尺寸。
经皮封堵引流至左心房的左上腔静脉具有良好的早期和长期预后。如有副半奇静脉引流，封堵器的最佳植入位置应在其引流部位下方。根据患者年龄，封堵器相对于左上腔静脉直径可能会偏大。
