Yoshibayashi M, Arakaki Y, Yamada O, Echigo S, Kamiya T
Department of Pediatrics, National Cardiovascular Center, Suita.
J Cardiol. 1987 Mar;17(1):199-206.
A 12-year-old girl with a univentricular heart and pulmonary stenosis, who had undergone Glenn operation at two years of age and Fontan operation at 11 years of age, had a right-to-left shunt via collaterals between the innominate and pulmonary veins. This right-to-left shunt was detected by two-dimensional contrast echocardiography. The contrast material was injected into the left antecubital vein appeared in the left atrium, and this was confirmed by innominate venography. The contrast material injected into the left innominate vein passed via the collaterals into the pulmonary veins bilaterally. No such cases have so far been reported. In our experience, in four of six cases after Glenn operation, including the present case, the abnormal collateral circulation from the superior vena cava to the atrium was detected by two-dimensional contrast echocardiography. This case is interesting embryologically and suggests that the connection between the pulmonary and systemic veins which is present in early fetal life, and subsequently disappears, was present after birth.
一名12岁患有单心室心脏和肺动脉狭窄的女孩，两岁时接受了格林手术，11岁时接受了Fontan手术，通过无名静脉和肺静脉之间的侧支形成右向左分流。这种右向左分流通过二维对比超声心动图检测到。注入左肘前静脉的造影剂出现在左心房，无名静脉造影证实了这一点。注入左无名静脉的造影剂通过侧支双侧进入肺静脉。迄今为止尚未报道过此类病例。根据我们的经验，在包括本病例在内的6例格林手术后病例中，有4例通过二维对比超声心动图检测到从上腔静脉到心房的异常侧支循环。该病例在胚胎学上很有趣，提示胎儿早期存在的肺静脉和体静脉之间的连接在出生后仍然存在，而这种连接随后会消失。
