Watanabe Toshitaka, Okamoto Kazuma, Yoshitani Nobuyuki, Tohma Ryo, Misato Takuya, Hayashi Taro
Department of Cardiovascular Surgery, Akashi Medical Center, Akashi, Japan.
Asian Cardiovasc Thorac Ann. 2021 May 11:2184923211017096. doi: 10.1177/02184923211017096.
For atrial septal defect closure via right minithoracotomy in an adult patient with infra-hepatic interruption of the inferior vena cava with azygos connection, an alternative venous cannulation strategy was applied. In addition to bicaval cannulations to the femoral vein and the internal jugular vein, a 20 Fr straight cannula draining the hepatic vein was added to the proximal IVC through the right atrium wall via a working port. A bloodless operative field in the right atrium was afforded with bicaval encircling. Preoperative imaging test of the continuity of the IVC was important planning cardiac surgery with peripheral cannulations.
对于一名患有肝下型下腔静脉中断并奇静脉连接的成年患者，经右胸小切口闭合房间隔缺损时，采用了一种替代的静脉插管策略。除了通过股静脉和颈内静脉进行双腔插管外，还通过一个操作端口经右心房壁将一根20 Fr的直插管插入下腔静脉近端，以引流肝静脉。通过双腔环绕可使右心房内术野无血。下腔静脉连续性的术前影像学检查对于计划采用外周插管的心脏手术非常重要。
