Victor S, Nayak V M
Department of Surgery, Heart Institute, Vadapalani, Madras, India.
Tex Heart Inst J. 1995;22(2):166-9.
We operated on a 14-year-old boy who had an echocardiographic diagnosis of ventricular septal defect. At surgery we found, in addition, an anomalous and obstructive intraventricular muscle bundle. Detection of a continuous thrill over the right pulmonary veins, prior to cardiopulmonary bypass, led to exploration of the left atrium. The ostia of the right superior and inferior pulmonary veins were impeded by circumferential membranous rings of endocardium with central stenotic openings. Excision of these annular rings relieved the obstruction. The left lung was drained by a long intrapericardial common venous channel that entered the left atrium through a stenotic ostium; excision of an annular ridge of endocardium restored normal flow. The patient remains asymptomatic after 23 months. The case is reported for the new deringing technique and the rarity of successful correction of congenital pulmonary vein stenosis.
我们为一名经超声心动图诊断为室间隔缺损的14岁男孩进行了手术。术中我们还发现了一条异常且阻塞性的室内肌束。在体外循环前，右肺静脉处持续可触及震颤，这促使我们对左心房进行探查。右上和右下肺静脉开口被心内膜的环形膜状结构所阻碍，中央有狭窄开口。切除这些环形结构解除了梗阻。左肺通过一条长的心包内共同静脉通道引流，该通道通过狭窄开口进入左心房；切除心内膜的环形嵴恢复了正常血流。患者在23个月后仍无症状。报道该病例是因为采用了新的解除梗阻技术以及先天性肺静脉狭窄成功矫正的罕见性。
