University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Semin Cardiothorac Vasc Anesth. 2020 Dec;24(4):374-377. doi: 10.1177/1089253220922334. Epub 2020 May 26.
Persistent left superior vena cava (PLSVC) is a rare abnormality with incidence reported as 0.3% to 0.5% in the general population and about 10 times higher in patients with congenital heart disease. The diagnosis of PLSVC in native or donor hearts of patients undergoing heart transplants has been reported in surgical journals. However, this rare finding has not been described in similar heart transplant settings in anesthesia literature. This case describes a 44-year-old male orthotopic heart transplant recipient who was incidentally diagnosed with PLSVC in his native heart on transesophageal echocardiogram after a central venous catheter placement. The particular position of the central venous catheter, in our case, raised the suspicion of PLSVC but needed further verification. With the help of images and videos, we demonstrate that transesophageal echocardiogram can be instrumental in diagnosing PLSVC. Furthermore, the case highlights the importance of effectively communicating with the surgeon about such a finding so that the surgical plan can be modified in a timely manner.
永存左上腔静脉（PLSVC）是一种罕见的异常，其在普通人群中的发病率为 0.3%至 0.5%，而在先天性心脏病患者中的发病率则高出约 10 倍。在接受心脏移植的患者的供体心脏或自体心脏中，外科杂志已经报道了 PLSVC 的诊断。然而，在麻醉文献中，尚未在类似的心脏移植环境中描述这种罕见的发现。本病例描述了一位 44 岁的男性原位心脏移植受者，在中心静脉导管放置后，经食管超声心动图偶然诊断出其自体心脏存在 PLSVC。在我们的病例中，中心静脉导管的特殊位置引起了对 PLSVC 的怀疑，但需要进一步证实。借助图像和视频，我们证明经食管超声心动图可用于诊断 PLSVC。此外，该病例强调了与外科医生有效沟通此类发现的重要性，以便及时修改手术计划。
