Konstam M A, Levine B W, Strauss H W, McKusick K A
Am J Cardiol. 1979 Jan;43(1):149-53. doi: 10.1016/0002-9149(79)90056-0.
Anomalous left superior vena cava to left atrial communication, although rare, should be considered in the presence of a right to left shunt without right ventricular hypertrophy, especially when the cause of the shunt cannot be identified at cardiac catheterization. We present a case with a diagnosis based on two radionuclide techniques. Nuclear angiography, performed after the injection of technetium-99m pertechnetate into the left arm, demonstrated the anomaly. Total body scans performed after intravenous injections of labeled albumin microspheres indicated 65% right to left shunting of left arm venous return but only 9% shunting of right arm venous return, findings that are diagnostic of left superior vena cava to left atrial communication.
左上腔静脉至左心房异常交通虽然罕见，但在存在右向左分流且无右心室肥厚时应予以考虑，尤其是在心脏导管检查无法确定分流原因的情况下。我们报告一例基于两种放射性核素技术做出诊断的病例。经左臂注射高锝酸盐99m后进行的核血管造影显示了这种异常。静脉注射标记白蛋白微球后进行的全身扫描显示，左臂静脉回流有65%的右向左分流，而右臂静脉回流只有9%的分流，这些发现可诊断为左上腔静脉至左心房交通。
