Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit, MI, USA.
Department of Pediatric Imaging, Children's Hospital of Michigan, Detroit, MI, USA.
World J Pediatr Congenit Heart Surg. 2020 Jul;11(4):NP229-NP231. doi: 10.1177/2150135118817491. Epub 2019 Apr 14.
During initial repair of supracardiac total anomalous pulmonary venous connection (TAPVC), the vertical vein (VV) is sometimes left patent (not ligated or divided) in the hope that this strategy may reduce the likelihood or severity of postoperative pulmonary hypertensive crises. We report a case of a 35-year-old pregnant patient with previously repaired supracardiac TAPVC who presented with atrial arrhythmia and right heart dilation. A cardiac magnetic resonance imaging study confirmed the diagnosis of patency of the vertical vein and right heart dilation. The VV was occluded with a catheter-delivered vascular occlusion device through a percutaneous approach, resulting in resolution of right heart dilation and arrhythmia. This case highlights the role of cross-sectional imaging as an adjunct to echocardiography in adults with repaired congenital heart disease.
在治疗心上型完全性肺静脉异位连接（TAPVC）的初始修复中，有时会保留垂直静脉（VV）的通畅（不结扎或不分离），希望这一策略可以降低术后肺动脉高压危象的可能性或严重程度。我们报告了一例 35 岁的妊娠合并心上型 TAPVC 修补术后患者，因房性心律失常和右心扩张就诊。心脏磁共振成像研究证实了垂直静脉通畅和右心扩张的诊断。通过经皮途径使用导管输送的血管闭塞装置闭塞 VV，导致右心扩张和心律失常得到解决。本病例强调了影像学在成人先天性心脏病中的作用，可作为超声心动图的补充。
