Tej Uday, Mishra Anand Kumar, Mittal Apeksha, Saini Kulbhushan, George Arun
Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh 160015, India.
Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Eur Heart J Case Rep. 2024 Jul 26;8(7):ytae290. doi: 10.1093/ehjcr/ytae290. eCollection 2024 Jul.
Total anomalous pulmonary venous connection (TAPVC) to left superior vena cava (LSVC) is an extremely rare congenital heart disease, and its surgical management is very challenging.
We report one such case of a 5-year-old south Asian male with double outlet right ventricle and unbalanced atrioventricular canal defect, where all the pulmonary veins were found opening into LSVC, which was then opening into the left side of the common atrium. Intraoperatively, the LSVC was transected just below the left internal jugular vein and left subclavian vein junction and left-sided bidirectional Glenn shunt done using 8 mm Dacron tube graft. Pulmonary veins were left draining through the LSVC into the common atrium. Right-sided Glenn shunt was completed as usual. Currently, the patient is year and half post-surgery and is doing well; school going on par with the peer group maintaining a room air saturation of 87%.
Here, we report a successful surgical correction of TAPVC to LSVC in a child with univentricular physiology, however due to the paucity of data and rarity of such cases, optimal surgical management is yet to be defined.
完全性肺静脉异位连接(TAPVC)至左上腔静脉(LSVC)是一种极其罕见的先天性心脏病,其外科治疗极具挑战性。
我们报告一例5岁南亚男性病例,患有右心室双出口和房室通道不平衡缺损,发现所有肺静脉均开口于LSVC,LSVC再开口于共同心房左侧。术中,在左颈内静脉和左锁骨下静脉交界处下方切断LSVC,并使用8毫米涤纶人工血管进行左侧双向格林分流术。肺静脉仍通过LSVC引流至共同心房。右侧格林分流术按常规完成。目前,该患者术后一年半,情况良好;上学表现与同龄人相当,室内空气饱和度维持在87%。
在此,我们报告了一例单心室生理患儿的TAPVC至LSVC的成功手术矫正,但由于数据匮乏且此类病例罕见,最佳手术治疗方案尚未明确。