Sakamoto S, Takano T, Adachi M, Itou J, Takekoshi N, Shimizu T
Division of Cardiology, Kanazawa Cardiovascular Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Nov;41(11):2202-5.
A successful repair of total right pulmonary venous return and intact atrial septum associated with patent left superior vena cava (PLSVC) is reported. A 31-year-old women was admitted for evaluation of heart failure. A heart murmur had been detected since her childhood without any subjective symptoms. She was diagnosed as partial anomalous venous return of all right pulmonary vein and intact atrial septum (IAS) associated with PLSVC by cardiac catheterization. Operative findings revealed that all right pulmonary vein connected to right atrium (RA) and superior vena cava (SVC), PLSVC drained into coronary sinous (CS), therefore RA, right ventricle and CS were enlarged, but SVC was small due to PLSVC. Through large incision from RA to SVC, atrial septum was opened 30 mm in diameter. Internal conduit using pericardial patch was made in order to drain anomalous pulmonary venous blood into left atrium through the ASD. Finally, SVC and RA were reconstructed by pericardial patch for prevention of conduit obstruction. One month after operation, no stenosis of SVC and right pulmonary vein was evidenced by cardiac catheterization and all through the postoperative course, arrhythmias did not detected. She was discharged with uneventful postoperative course.
报道了一例成功修复完全性右肺静脉回流且房间隔完整并伴有左上腔静脉（PLSVC）的病例。一名31岁女性因心力衰竭入院评估。自童年起就发现有心脏杂音，但无任何主观症状。经心导管检查，她被诊断为所有右肺静脉部分异常回流且房间隔完整（IAS）并伴有PLSVC。手术发现所有右肺静脉与右心房（RA）和上腔静脉（SVC）相连，PLSVC引流至冠状窦（CS），因此RA、右心室和CS增大，但由于PLSVC，SVC较小。通过从RA到SVC的大切口，打开直径为30毫米的房间隔。制作了使用心包补片的内部管道，以便通过房间隔缺损将异常的肺静脉血引流至左心房。最后，用心包补片重建SVC和RA以防止管道阻塞。术后1个月，心导管检查未发现SVC和右肺静脉狭窄，且在整个术后过程中未检测到心律失常。她术后恢复顺利，已出院。
