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在伴有房室间隔缺损的陶西格-宾畸形情况下,脐静脉重复并伴有一条肝外、胸腔内的右脐静脉。

Duplication of the umbilical vein along with an extrahepatic, intrathoracic right umbilical vein in the setting of Taussig-Bing anomaly with atrioventricular septal defect.

作者信息

Soveyzi Faezeh, Soleimani Hourieh, Aleebrahim-Dehkordi Elahe, Jandaghi Jamal

机构信息

Department of Radiology, Mashhad University of Medical Sciences, Mashhad, Iran.

The Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Indian J Thorac Cardiovasc Surg. 2025 Jul;41(7):919-923. doi: 10.1007/s12055-024-01885-5. Epub 2024 Dec 27.

Abstract

UNLABELLED

The incidence of persistent right umbilical vein (PRUV) is approximately 2 per 1000 pregnancies, with cases utilizing extrahepatic and intrathoracic routes to connect to the superior vena cava (SVC) being notably rarer. The case in question involved an 18-week fetus presenting with concurrent cardiac anomalies: D-transposition of the great arteries (TGA) classified as Taussig-Bing anomaly and atrioventricular septal defect (AVSD), highlighting the uniqueness of the presentation. A second-trimester ultrasound, including echocardiographic assessment, identified Taussig-Bing anomaly, AVSD, pulmonary stenosis (PS), and a right-sided stomach position with a left-sided umbilical vein exhibiting a PRUV with an anomalous trajectory towards the SVC. These findings indicate a rare association of multiple congenital malformations. The right-sided stomach raised concerns for potential cardiosplenic syndromes, such as heterotaxy. Additionally, two vessels observed posterior to the heart in the four-chamber view raised suspicion for inferior vena cava (IVC) interruption, possibly suggesting an azygos vein formation. However, a thorough assessment of the IVC confirmed normal anatomy, with the posterior vessel identified as the PRUV.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12055-024-01885-5.

摘要

未标注

持续性右脐静脉(PRUV)的发生率约为每1000例妊娠中有2例,通过肝外和胸腔内途径连接至上腔静脉(SVC)的病例尤为罕见。该病例为一名18周的胎儿,同时存在心脏异常:大动脉D型转位(TGA),分类为陶西格-宾氏畸形和房室间隔缺损(AVSD),突出了该病例表现的独特性。孕中期超声检查,包括超声心动图评估,发现了陶西格-宾氏畸形、AVSD、肺动脉狭窄(PS),以及胃位于右侧且脐静脉位于左侧,表现为PRUV并伴有一条朝向SVC的异常走行。这些发现表明存在多种先天性畸形的罕见关联。胃位于右侧引发了对潜在的心脾综合征(如内脏反位)的担忧。此外,在四腔心切面中观察到心脏后方有两条血管,这引发了对下腔静脉(IVC)中断的怀疑,可能提示奇静脉形成。然而,对IVC的全面评估证实解剖结构正常,后方的血管被确定为PRUV。

补充信息

在线版本包含可在10.1007/s12055-024-01885-5获取的补充材料。

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本文引用的文献

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Advances in the Application of Artificial Intelligence in Fetal Echocardiography.人工智能在胎儿超声心动图中的应用进展。
J Am Soc Echocardiogr. 2024 May;37(5):550-561. doi: 10.1016/j.echo.2023.12.013. Epub 2024 Jan 9.
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Ultrasound of fetal cardiac anomalies.胎儿心脏畸形的超声检查。
AJR Am J Roentgenol. 2011 Oct;197(4):W747-60. doi: 10.2214/AJR.10.7287.
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Persistent right umbilical vein: incidence and significance.永存右脐静脉:发生率及意义
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