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因腔静脉改道至左心房导致的医源性术后发绀及其经导管治疗

Iatrogenic Post-Surgical Cyanosis Due to Vena Caval Redirection to the Left Atrium and Its Transcatheter Management.

作者信息

Sivakumar Kothandam, Sagar Pramod, Thejaswi Puthiyedath, Pavithran Sreeja

机构信息

Department of Pediatric Cardiology, Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, 600089, India.

Institute of Cardio Vascular Diseases, Madras Medical Mission, 4A Dr J J Nagar, Mogappair, Chennai, 600037, India.

出版信息

Pediatr Cardiol. 2024 Dec 13. doi: 10.1007/s00246-024-03729-w.

Abstract

During surgery for oval fossa defects, inadvertent suturing of pericardial patches to a prominent Eustachian valve diverts the inferior vena caval blood to the left atrium causing iatrogenic cyanosis. A similar complication may arise after surgery for superior sinus venosus defects. Surgical patch in a wrong plane may direct the superior vena cava towards the left atrium. Early post-operative diagnosis leads to immediate correction. Diagnosis delayed beyond many years lead to chronic hypoxemia and secondary polycythemia. This report details the clinical presentation and imaging of this iatrogenic complication in three patients and explains a transcatheter corrective intervention.

摘要

在卵圆窝缺损手术过程中,若不小心将心包补片缝至明显的欧氏瓣,会使下腔静脉血分流至左心房,导致医源性紫绀。上腔静脉窦缺损手术后也可能出现类似并发症。手术补片置于错误平面可能会使上腔静脉血流入左心房。术后早期诊断可立即进行纠正。若诊断延误多年,则会导致慢性低氧血症和继发性红细胞增多症。本报告详细介绍了3例该医源性并发症的临床表现及影像学表现,并阐述了经导管纠正干预措施。

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