Pediatric Cardiology Unit, Department of Woman and Child's Health, University of Padua, Padua, Italy.
Echocardiography. 2021 Jul;38(7):1201-1204. doi: 10.1111/echo.15054. Epub 2021 May 24.
An 11-year-old boy affected by pulmonary atresia with intact ventricular septum (AP-IVS) was listed for percutaneous pulmonary valvuloplasty and closure of multi-fenestrated atrial septal defect (ASD). Intra-procedural transesophageal echocardiography arose the suspect of abnormal coronary artery pattern while selective angiography documented a single sinoatrial node artery (SANa) with an unusual retro-aortic course. As consequence, we proceeded to effectively close the defects with a not self-centering device placed in the most central side hole. This case supports the hypothesis that sometimes arrhythmic complication during ASD closure procedures might be due to unrecognized injury of the SANa.
一名 11 岁男孩患有肺动脉闭锁伴完整室间隔缺损（AP-IVS），被列入经皮肺动脉瓣成形术和多孔房间隔缺损（ASD）封堵术的名单。术中经食管超声心动图怀疑存在异常冠状动脉模式，而选择性血管造影则记录到单一窦房结动脉（SANa）呈异常主动脉后走行。因此，我们使用一个不能自动居中的装置，将其放置在最中央的侧孔处，有效地关闭了这些缺陷。这个病例支持这样一种假设，即 ASD 封堵过程中的心律失常并发症有时可能是由于未被识别的 SANa 损伤引起的。
