Department of Surgery, Faculty of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan.
Department of Surgery, Kofu Municipal Hospital, 366 Masutsubo, Kofu City, Yamanashi, Japan.
Gen Thorac Cardiovasc Surg. 2021 Sep;69(9):1313-1319. doi: 10.1007/s11748-021-01639-9. Epub 2021 Apr 26.
There are only limited reports on pulmonary resection complicated with partial anomalous pulmonary venous connection. Preoperative partial anomalous pulmonary venous connection was overlooked in approximately 50% of these reports, while most cases of were located on the same side as the pulmonary resection. We examined the prevalence of overlooked partial anomalous pulmonary venous connection and determined appropriate measures to avoid misdiagnosis.
We retrospectively reviewed the records and computed tomography data of consecutive patients who underwent pulmonary resection at the University of Yamanashi Hospital between 2006 and 2019. We re-evaluated the computed tomography images in horizontal and coronal views, focusing on the four common sites of partial anomalous pulmonary venous connection. Further, we conducted a literature review of studies that reported partial anomalous pulmonary venous connection cases.
Among the 1389 patients who underwent pulmonary resection, 1205 were enrolled. There were five partial anomalous pulmonary venous connection cases (0.41%). Two were diagnosed through re-evaluation. The partial anomalous pulmonary venous connection was located between the right upper lobe and the superior vena cava in four patients (80%). All patients underwent left superior segmentectomy, and none experienced postoperative heart failure or hypoxia. In the literature, the incidence rates of partial anomalous pulmonary venous connection observed by computed tomography (0.1-0.25%) were lower than those observed by autopsy (0.62%) and angiography (0.82%).
There may be a considerable number of overlooked partial anomalous pulmonary venous connection cases. Therefore, particularly the superior vena cava should be carefully monitored in preoperative computed tomography examinations.
仅有有限的关于肺切除术后合并部分肺静脉异常连接的报道。这些报道中约有 50%术前漏诊了部分肺静脉异常连接，且大多数病例位于与肺切除术相同的一侧。我们检查了漏诊的部分肺静脉异常连接的发生率，并确定了避免误诊的适当措施。
我们回顾性地审查了 2006 年至 2019 年期间在山梨大学医院接受肺切除术的连续患者的病历和计算机断层扫描（CT）数据。我们重新评估了水平和冠状视图的 CT 图像，重点关注四个常见的部分肺静脉异常连接部位。此外，我们对报告部分肺静脉异常连接病例的文献进行了综述。
在接受肺切除术的 1389 例患者中，有 1205 例被纳入研究。共有 5 例部分肺静脉异常连接病例（0.41%）。其中 2 例通过重新评估诊断。4 例患者的部分肺静脉异常连接位于右上叶和上腔静脉之间（80%）。所有患者均接受了左肺上叶前段切除术，术后均无心力衰竭或缺氧发生。文献中 CT 观察到的部分肺静脉异常连接发生率（0.1-0.25%）低于尸检（0.62%）和血管造影（0.82%）。
可能存在相当数量的漏诊部分肺静脉异常连接病例。因此，在术前 CT 检查中，特别是应仔细监测上腔静脉。
