Sawa H, Furuse S, Okamoto Y, Saito S
No Shinkei Geka. 1984 Mar;12(3 Suppl):383-7.
A case of congenital subclavian steal is reported. A 7-year-old girl was admitted on July 1980 to Shimane Medical University for evaluation of murmur over the region of the chest. Heart murmur was pointed out at the age of three month, however, she had no complaints and was growing normally. On admission, the blood pressure was 108/48 mmHg in the left arm and unobtainable in the right arm. The length of the arm was 53 cm on the right side and 55.4 cm on the left side. On auscultation, a systolic murmur was present over the chest and the right neck. The arch aortography disclosed the left aortic arch, the isolation of the right subclavian artery and the right patent ductus arteriosus (PDA). The left transfemoral vertebral angiography showed the retro-grade filling from the right vertebral artery to the right subclavian and pulmonary artery via the right PDA. The right external carotid angiography showed the filling of the right vertebral artery through muscular branches of the right occipital artery. The right retrograde brachial angiography showed small right subclavian artery and the filling of the pulmonary artery through the right PDA. The recorrective operation was made. Postoperatively, normal blood flow was recognized in angiography. The blood pressure improved in the right side and the murmur was diminished.
报道了一例先天性锁骨下动脉盗血病例。一名7岁女孩于1980年7月入住岛根医科大学,以评估胸部区域的杂音。三个月大时发现心脏杂音,但她没有任何不适,生长发育正常。入院时,左臂血压为108/48 mmHg,右臂无法测得血压。右臂长度为53 cm,左臂长度为55.4 cm。听诊时,胸部和右颈部可闻及收缩期杂音。主动脉弓造影显示为左主动脉弓,右锁骨下动脉孤立,右动脉导管未闭(PDA)。左股动脉椎动脉造影显示,通过右PDA,血液从右椎动脉逆行充盈至右锁骨下动脉和肺动脉。右颈外动脉造影显示,通过右枕动脉的肌支,右椎动脉得以充盈。右逆行肱动脉造影显示右锁骨下动脉细小,且通过右PDA有血液充盈至肺动脉。进行了矫正手术。术后,血管造影显示血流正常。右侧血压改善,杂音减轻。