Mądry Wojciech, Karolczak Maciej A, Grabowski Krzysztof
Department of Cardiac Surgery and General Pediatric Surgery, Medical University of Warsaw , Warsaw , Poland.
J Ultrason. 2019;19(76):71-74. doi: 10.15557/JoU.2019.0011.
We report the case of a 2.5-year-old boy with atrial septal defect in whom anomalous position of the left innominate vein was detected on preoperative ultrasound examination. Before joining the right brachiocephalic vein, the vessel extended from the left to the right and downward beyond the descending aorta. It was considerably flattened by the thoracic vertebral column, and was invisible on ultrasonography in this section. The appearance of the visible segments raised a suspicion of an anomalous course of persistent left superior vena cava draining into the left atrium, dilated azygos vein in a case of interrupted inferior vena cava, or partial anomalous pulmonary venous return. Since all doubts had to be resolved before open heart surgery, a decision was made to expand the diagnostic work-up to include computed tomography angiography. We present the echocardiographic and computed tomography findings of this unusual and previously unreported case of anomalous venous return. We report the case of a 2.5-year-old boy with atrial septal defect in whom anomalous position of the left innominate vein was detected on preoperative ultrasound examination. Before joining the right brachiocephalic vein, the vessel extended from the left to the right and downward beyond the descending aorta. It was considerably flattened by the thoracic vertebral column, and was invisible on ultrasonography in this section. The appearance of the visible segments raised a suspicion of an anomalous course of persistent left superior vena cava draining into the left atrium, dilated azygos vein in a case of interrupted inferior vena cava, or partial anomalous pulmonary venous return. Since all doubts had to be resolved before open heart surgery, a decision was made to expand the diagnostic work-up to include computed tomography angiography. We present the echocardiographic and computed tomography findings of this unusual and previously unreported case of anomalous venous return.
我们报告一例2.5岁患有房间隔缺损的男孩，其在术前超声检查中被发现左无名静脉位置异常。在汇入右头臂静脉之前，该血管从左侧延伸至右侧并向下延伸至降主动脉下方。它被胸椎显著压扁，在该部位的超声检查中不可见。可见节段的表现引发了对持续左上腔静脉异常走行汇入左心房、下腔静脉中断时奇静脉扩张或部分肺静脉异位回流的怀疑。由于在心脏直视手术前必须解决所有疑问，因此决定扩大诊断检查范围，包括计算机断层血管造影。我们展示了这例异常静脉回流的罕见且此前未报道病例的超声心动图和计算机断层扫描结果。我们报告一例2.5岁患有房间隔缺损的男孩，其在术前超声检查中被发现左无名静脉位置异常。在汇入右头臂静脉之前，该血管从左侧延伸至右侧并向下延伸至降主动脉下方。它被胸椎显著压扁，在该部位的超声检查中不可见。可见节段的表现引发了对持续左上腔静脉异常走行汇入左心房、下腔静脉中断时奇静脉扩张或部分肺静脉异位回流的怀疑。由于在心脏直视手术前必须解决所有疑问，因此决定扩大诊断检查范围，包括计算机断层血管造影。我们展示了这例异常静脉回流的罕见且此前未报道病例的超声心动图和计算机断层扫描结果。
