Nagasawa Hiroyuki, Kuwabara Naoki, Goto Hiroko, Omoya Kentarou, Yamamoto Tetsuya, Terazawa Atsushi, Kohno Yoshinori, Kuwahara Takashi
Department of Neonatology, Gifu Prefectural General Medical Center, 4-6-1 Noisshiki, Gifu, 500-8717, Japan.
Department of Pediatric Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan.
Pediatr Cardiol. 2018 Mar;39(3):484-490. doi: 10.1007/s00246-017-1778-3. Epub 2017 Nov 27.
Reports on the incidence of persistent left superior vena cava (PLSVC) in the normal population are limited to studies involving pacemaker implantation candidates and cadavers. The incidence in patients with congenital heart diseases (CHDs) is estimated to be higher than that in the normal population; however, the details are unclear. To investigate the incidence of PLSVC in the normal population and in patients with CHDs, subjects were examined prospectively using echocardiography. Normal subjects consisted of 2841 successive neonates without intra-cardiac or congenital anomalies born in Gifu Prefectural General Medical Center. Additionally, 1920 patients with CHDs were evaluated. The incidence of PLSVC in normal neonates was 0.21% (95% confidence interval 0.042-0.38%). A high incidence (more than 7.0 times the incidence in normal subjects) was observed in all CHD patients. The high incidence group included coarctation of the aorta (CoA) (23.7%) and double outlet right ventricle (DORV) patients (24.6%). The second group consisted of CHD patients with ventricular septal defect (VSD), with an incidence ranging from 5.1 to 6.1%. The low incidence group comprised patients with other CHDs, with an incidence between 1.5 and 3.1%. The incidence of PLSVC in trisomy 21 and atrial septal defect patients was significantly higher than that in normal neonates. The incidence of PLSVC in the normal population and in patients with CHDs was systematically evaluated for the first time. The incidence in CHD patients appeared to be positively influenced by the type of CHD, particularly by DORV, CoA, and VSD.
关于正常人群中永存左上腔静脉(PLSVC)发生率的报告仅限于涉及起搏器植入候选者和尸体的研究。先天性心脏病(CHD)患者中的发生率估计高于正常人群;然而,具体情况尚不清楚。为了调查正常人群和CHD患者中PLSVC的发生率,采用超声心动图对受试者进行了前瞻性检查。正常受试者包括岐阜县综合医疗中心连续出生的2841例无心脏内或先天性异常的新生儿。此外,对1920例CHD患者进行了评估。正常新生儿中PLSVC的发生率为0.21%(95%置信区间0.042 - 0.38%)。在所有CHD患者中均观察到高发生率(比正常受试者的发生率高7.0倍以上)。高发生率组包括主动脉缩窄(CoA)患者(23.7%)和右心室双出口(DORV)患者(24.6%)。第二组为室间隔缺损(VSD)的CHD患者,发生率在5.1%至6.1%之间。低发生率组包括其他CHD患者,发生率在1.5%至3.1%之间。21三体综合征和房间隔缺损患者中PLSVC的发生率显著高于正常新生儿。首次系统评估了正常人群和CHD患者中PLSVC的发生率。CHD患者中的发生率似乎受到CHD类型的积极影响,特别是DORV、CoA和VSD。