An Crystal, Kindzelski Bogdan A, Tong Michael Z Y, Soltesz Edward G, Weiss Aaron J
Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio; Kaufman Center for Heart Failure and Recovery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio; Kaufman Center for Heart Failure and Recovery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
Transplant Proc. 2023 Apr;55(3):691-692. doi: 10.1016/j.transproceed.2023.02.022. Epub 2023 Mar 15.
A persistent left superior vena cava (PLSVC) is a congenital anomaly wherein the left superior cardinal vein fails to regress. We describe the case of a successful orthotopic heart transplant using a donor heart with a PLSVC and congenital absence of a right superior vena cava (SVC) in a recipient with normal anatomy. After donor cardiectomy, the donor organ's PLSVC was ligated near the insertion site into the coronary sinus. The recipient underwent cardiectomy such that the native SVC was left with a long right atrial cuff. A modified bicaval technique was used to anastomose the recipient's right atrial cuff directly to the donor's right atrial appendage. This technique restored the recipient's normal anatomy, and we demonstrated that donor hearts with a PLSVC and absent right SVC might be used for transplant. Without other disqualifying abnormalities, surgeons should consider accepting these organs for life-saving transplant operations.
永存左上腔静脉（PLSVC）是一种先天性异常，即左上主静脉未能退化。我们描述了一例原位心脏移植成功的病例，供体心脏存在PLSVC且先天性无右上腔静脉（SVC），而受体解剖结构正常。供体心脏切除术后，供体器官的PLSVC在插入冠状窦的部位附近结扎。受体接受心脏切除术，使自体SVC保留一个长的右心房袖套。采用改良双腔技术将受体的右心房袖套直接与供体的右心耳吻合。该技术恢复了受体的正常解剖结构，并且我们证明具有PLSVC和无右上腔静脉的供体心脏可用于移植。在没有其他不合格异常的情况下，外科医生应考虑接受这些器官用于挽救生命的移植手术。
