Ichihara T, Watanabe T, Teranishi K, Yasuura K, Tanaka M, Nagashima M
Department of Thoracic Surgery, Nagoya University School of Medicine, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1995 Apr;43(4):497-501.
We performed the new operative method for bilateral partial anomalous pulmonary connections (PAPVC) without atrial septal defect (ASD). A 11-years-old boy was admitted for operation. The right upper pulmonary vein returned to the superior vena cave (SVC), and left upper pulmonary vein returned to the innominate vein. Atrial septum was intact. The Qp/Qs was 1.94. The right atrium (RA) was opened and ASD was created. Continuity between the distal end of the SVC and RA was re-established by end-to-end anastomosis to the right atrial appendage. The proximal end of the SVC was closed. The right anomalous pulmonary vein remained in situ on the lower segment of SVC, blood being directed to the left atrium (LA) through the created ASD by suturing the posterior flap of RA incision to the atrial septum well away from the sinoatrial node and artery, anomalous pulmonary vein and cavoatrial junction. The anomalous left vertical vein was dissected up to the innominate vein. The left pulmonary vein was mobilized as much as possible, and was anastomosed to the posterior wall of LA by end-to-side fashion. He has normal sinus rhythm and no evidence of pulmonary venous obstructions on both sides. We support the efficacy of this method as an alternative in the management of this disorder.
我们对无房间隔缺损（ASD）的双侧部分性肺静脉异常连接（PAPVC）实施了新的手术方法。一名11岁男孩入院接受手术。右上肺静脉回流至上腔静脉（SVC），左上肺静脉回流至无名静脉。房间隔完整。肺循环血流量与体循环血流量之比（Qp/Qs）为1.94。打开右心房（RA）并制造房间隔缺损。通过将SVC远端与右心耳进行端端吻合，重建SVC与RA之间的连续性。关闭SVC近端。右异常肺静脉保留在SVC下段原位，通过将RA切口的后瓣缝合至远离窦房结、动脉、异常肺静脉和腔房连接的房间隔，使血液通过制造的房间隔缺损流向左心房（LA）。游离异常的左垂直静脉直至无名静脉。尽可能游离左肺静脉，并以端侧方式吻合至LA后壁。他窦性心律正常，双侧均无肺静脉梗阻迹象。我们支持该方法作为治疗这种疾病的一种替代方法的有效性。
