Sarkar Subhadeep, Jana Sayandeep
Department of Cardiac Anaesthesia and Critical Care, NH Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India.
Ann Card Anaesth. 2025 Apr 1;28(2):184-186. doi: 10.4103/aca.aca_202_24. Epub 2025 Apr 16.
Routes for transcatheter closure of ostium secundum atrial septal defect (OS ASD) by device implantation include hepatic vein & jugular vein besides standard transfemoral approach. We report the case of a female child with OS ASD, who presented with an anomalous systemic venous drainage. Only the hepatic vein was draining directly to RA hence the only option left was transhepatic. Multidisciplinary consensus was taken and the procedure proceeded under general anaesthesia. To avoid cathlab misadventures, tracing systemic venous drainage besides pulmonary venous drainage in a case of OS ASD is important. The anaesthetist should be aware of the transhepatic approach and possible complications which may arise. Preparedness for the complications and invasive monitoring ensures success for this challenging procedure.
经导管通过装置植入闭合继发孔型房间隔缺损（OS ASD）的途径除了标准的经股途径外，还包括肝静脉和颈静脉。我们报告了一例患有OS ASD的女童病例，该女童存在异常的体静脉引流。只有肝静脉直接引流至右心房（RA），因此剩下的唯一选择是经肝途径。我们进行了多学科会诊，并在全身麻醉下进行了该手术。为避免心导管室意外情况，在OS ASD病例中，除了追踪肺静脉引流外，追踪体静脉引流也很重要。麻醉医生应了解经肝途径及可能出现的并发症。对并发症做好准备并进行有创监测可确保这一具有挑战性的手术取得成功。
