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[永存左上腔静脉患者二尖瓣成形术的手术经验;病例报告]

[Surgical Experience of Mitral Valve Plasty in Patient with Persistent Left Superior Vena Cava;Report of a Case].

作者信息

Akabane Kentaro, Uchida Tetsuro, Hamasaki Azumi, Kuroda Yoshinori, Mizumoto Masahiro, Yamashita Atsushi, Hirooka Syuto, Ishizawa Ai, Sadahiro Mitsuaki

机构信息

Second Department of Surgery, Yamagata University, Yamagata, Japan.

出版信息

Kyobu Geka. 2019 Jun;72(6):459-462.

Abstract

A 45-year-old man diagnosed with severe mitral regurgitation was admitted to our hospital for surgical treatment. Preoperative computed tomographic imaging revealed a persistent left superior vena cava. At operation, cardiopulmonary bypass was established with ascending aortic and bicaval cannulation. In addition to 2 venous cannulas, we directly cannulated to the left superior vena cava for sufficient venous drainage. Mitral valve plasty consisted of triangular resection of P2 segment was performed through the right side left atriotomy. Postoperative course was uneventful and echocardiography 3 months after the operation showed trivial mitral regurgitation. Precise preoperative evaluation concerning the persistent left superior vena cava should be mandatory for appropriate management of cardiopulmonary bypass.

摘要

一名45岁被诊断为重度二尖瓣反流的男性因手术治疗入住我院。术前计算机断层扫描成像显示存在永存左上腔静脉。手术时,采用升主动脉和双腔静脉插管建立体外循环。除了两根静脉插管外,我们还直接向左上腔静脉插管以实现充分的静脉引流。通过右侧左心房切口进行二尖瓣成形术,包括P2段三角形切除。术后过程顺利,术后3个月的超声心动图显示二尖瓣微量反流。对于体外循环的适当管理,术前对永存左上腔静脉进行精确评估应是必不可少的。

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