Mooney D P, Snyder C L, Holder T M
Department of Surgery, Children's Mercy Hospital, Kansas City, MO 64108.
J Pediatr Surg. 1993 Dec;28(12):1633-4. doi: 10.1016/0022-3468(93)90125-5.
A persistent left superior vena cava (PLSVC) is the most common anomaly of the major veins. However, an absent right superior vena cava and PLSVC is much less common; fewer than 100 cases have been reported in the world literature in patients with situs solitus. This rare variation was encountered in a newborn requiring extracorporeal membrane oxygenation (ECMO) for meconium aspiration and interfered with venous cannulation. The anomaly was not suspected before an unusual cannula position was observed on the chest radiograph, and it was confirmed by bedside venography. Adequate venous cannulation was obtained through the anomalous vessel using a flexible catheter, allowing for an uneventful ECMO course. The epidemiology and embryology of this incidental anomaly are reviewed, and the methods used to circumvent the difficulties it presented in this case are described.
永存左上腔静脉（PLSVC）是主要静脉中最常见的异常情况。然而，右位上腔静脉缺如合并PLSVC则极为罕见；在世界文献中，报道的 situs solitus 患者中少于100例。这种罕见变异在一名因胎粪吸入需要体外膜肺氧合（ECMO）的新生儿中出现，并干扰了静脉插管。在胸部X线片上观察到异常插管位置之前，并未怀疑存在该异常，随后经床边静脉造影得以证实。通过使用柔性导管经异常血管成功进行了充分的静脉插管，使ECMO过程顺利。本文回顾了这种偶然发现的异常的流行病学和胚胎学，并描述了在该病例中克服其所带来困难的方法。
