Tuccillo Andrea, Giordano Mario, Gaio Gianpiero, Carrozza Marianna, Cappelli-Bigazzi Maurizio, Morelli Carmela, Ait-Ali Lamia, Festa Pierluigi, Russo Maria Giovanna
"Monaldi" Hospital, University of Campania "Luigi Vanvitelli", "Ospedali dei Colli", Naples, Italy.
"Ospedale del Cuore", Tuscany-CNR Foundation "G. Monasterio", Massa, Italy.
J Cardiol Cases. 2020 Sep 21;23(2):65-68. doi: 10.1016/j.jccase.2020.09.002. eCollection 2021 Feb.
The levoatriocardinal vein is a rare vascular anomalous connection between the left atrium and the superior vena cava (or left innominate vein). This defect is usually associated with left heart obstructive lesions, while it is rarely found in an isolated form. In the former case, the anomalous connection causes a pre-tricuspid left-to-right shunt with right-heart volume overload. We describe the first case of "double" homolateral levoatriocardinal vein in a child with signs and symptoms of right-heart failure and pulmonary blood-flow overload. A trans-catheter closure of both vascular connections was performed with two Amplatzer Vascular Plug type II (Abbott, Plymouth, MN, USA). The percutaneous approach proved to be safe and effective, with early improvement in the signs and symptoms of heart failure. < This case report cautions us to consider the levoatriocardinal vein as a possible finding in infants or children with right-heart overload in absence of other congenital heart lesions. Furthermore, the presence of a "double" levoatriocardinal connection may worsen the pulmonary blood-flow overload with early onset of symptoms. The trans-catheter approach is effective to deal with the congenital lesion.>.
左心房-上腔静脉连接是一种罕见的左心房与上腔静脉（或左无名静脉）之间的血管异常连接。这种缺陷通常与左心梗阻性病变相关，而孤立形式则很少见。在前一种情况下，异常连接导致三尖瓣前的左向右分流，使右心容量负荷过重。我们描述了第一例“双”同侧左心房-上腔静脉连接的儿童病例，该患儿有右心衰竭和肺血流过载的体征和症状。使用两个美国雅培公司生产的II型Amplatzer血管封堵器经导管封闭了两个血管连接。经皮途径被证明是安全有效的，心力衰竭的体征和症状早期得到改善。<本病例报告提醒我们，在没有其他先天性心脏病变的情况下，对于右心负荷过重的婴儿或儿童，要考虑到左心房-上腔静脉连接这一可能的发现。此外，“双”左心房-上腔静脉连接的存在可能会使肺血流过载恶化，并使症状早发。经导管方法对处理这种先天性病变是有效的。>
