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部分性肺静脉异位连接合并偶然发现的迷走右锁骨下动脉:一例罕见病例报告。

Partial anomalous pulmonary venous connection and an incidental aberrant right subclavian artery: A rare case report.

作者信息

Khadka Ashish, Neupane Aakash, Yadav Pramodman Singh, Shah Leeza, Dev Abinash, Ghale Sabin, Karki Amisha

机构信息

Department of Radiodiagnosis and Imaging, National Academy of Medical Sciences, Kathmandu, Nepal.

Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.

出版信息

Radiol Case Rep. 2025 Feb 1;20(4):2184-2188. doi: 10.1016/j.radcr.2025.01.027. eCollection 2025 Apr.

Abstract

Partial anomalous pulmonary venous connection (PAPVC) is a rare congenital heart defect where some pulmonary veins drain into the right atrium instead of the left. We report a case of a 20-year-old female with worsening dyspnea and intermittent chest pain. Imaging revealed cardiomegaly and pulmonary hypertension on chest X-ray. Contrast-enhanced CT showed normal right pulmonary vein drainage but anomalous drainage of the left pulmonary veins into the left brachiocephalic vein. An incidental finding of an aberrant right subclavian artery (ARSA) was also noted. The patient underwent successful surgical correction of PAPVC, with no postoperative complications, though long-term follow-up was unavailable. PAPVC is often asymptomatic but can lead to right-sided heart failure and pulmonary hypertension if untreated. ARSA, a rare anomaly, was not clinically significant in this case. This report emphasizes the role of advanced imaging in diagnosing rare anomalies like PAPVC and ARSA, where early detection and intervention are crucial for preventing complications like right ventricular dysfunction and arrhythmias.

摘要

部分性肺静脉异位连接(PAPVC)是一种罕见的先天性心脏缺陷,其中一些肺静脉引流至右心房而非左心房。我们报告一例20岁女性,其呼吸困难加重且伴有间歇性胸痛。胸部X线成像显示心脏扩大和肺动脉高压。增强CT显示右肺静脉引流正常,但左肺静脉异常引流至左头臂静脉。还偶然发现了一条迷走右锁骨下动脉(ARSA)。该患者接受了PAPVC的成功手术矫正,术后无并发症,不过无法进行长期随访。PAPVC通常无症状,但如果不治疗可导致右心衰竭和肺动脉高压。ARSA是一种罕见的异常情况,在本病例中无临床意义。本报告强调了先进成像在诊断PAPVC和ARSA等罕见异常中的作用,早期发现和干预对于预防右心室功能障碍和心律失常等并发症至关重要。

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