Choi J Y, Anderson R H, Macartney F J
Br Heart J. 1987 May;57(5):474-8. doi: 10.1136/hrt.57.5.474.
Eight cases of absent right superior caval vein (vena cava) with normal atrial arrangement from the Great Ormond Street database were reviewed. In each case the right subclavian vein and jugular vein drained into a persistent left superior caval vein through a bridging vein. In six cases the left superior caval vein drained into the right atrium by way of the coronary sinus, and in two cases it drained into the left atrium directly because of the complete unroofing of the coronary sinus. The frontal plane P wave axis was displaced leftwards and upwards in four out of seven cases in which an electrocardiogram was available. No case showed arrhythmia on a standard electrocardiogram preoperatively. Echocardiograms were available in four cases and in each case diagnosis of the anomalous connections of the systemic vein was possible. Only one third of the cases showed a crescentic shadow of the persistent left superior caval vein on chest x ray. A chest x ray and electrocardiogram do not provide the means of reliable diagnosis of this condition, though they may suggest the possibility of its existence. Definitive diagnosis requires cross sectional echocardiography or angiocardiography or both.
回顾了大奥蒙德街数据库中8例右头臂静脉缺如但心房排列正常的病例。在每例病例中，右锁骨下静脉和颈静脉通过一条桥静脉汇入永存左上腔静脉。6例中，左上腔静脉经冠状窦汇入右心房；2例中，由于冠状窦完全无顶，左上腔静脉直接汇入左心房。在有心电图的7例病例中，4例额面P波电轴向左上移位。术前标准心电图检查无一例显示心律失常。4例有超声心动图检查结果，每例均能诊断体静脉异常连接。胸部X线片仅三分之一的病例显示永存左上腔静脉的新月形阴影。胸部X线片和心电图虽可能提示本病存在的可能性，但不能提供可靠的诊断方法。明确诊断需要横断面超声心动图或心血管造影或两者均用。
