Hijii T, Fukushige J, Hara T
Department of Pediatrics, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Cardiology. 1998;89(2):148-51. doi: 10.1159/000006771.
Medical records, angiograms and operative records of 28 patients with partial anomalous pulmonary venous connection (PAPVC) were reviewed. Twenty patients had one anomalous pulmonary vein (APV), and 8 had more than two APVs. Twenty-five patients (89%) had APVs originating from the right lung, 2 (7%) from the left lung and 1 (4%) from both lungs. In the 25 patients with APVs originating from the right lung, 9 had APVs draining into the superior vena cava (SVC), 13 into the right atrium (RA), 1 into the inferior vena cava (IVC) and 2 into both the SVC and RA. In the 2 patients with APVs originating from the left lung, 1 had APVs draining into the RA, and the other had APVs draining into the innominate vein. The patient with APVs originating from both lungs had connection to the IVC. Twenty-three patients (82%) had additional cardiovascular defects. Surgery was performed in 13 patients who had pulmonary/systemic flow ratios greater than 2.0. The patients have done well after surgery. In 7 patients, we were unable to accurately determine the number or sites of drainage of APVs prior to surgery. We conclude that selective pulmonary angiography is indispensable for the accurate diagnosis of PAPVC.
回顾了28例部分性肺静脉异位连接（PAPVC）患者的病历、血管造影和手术记录。20例患者有1条肺静脉异位（APV），8例有两条以上APV。25例（89%）患者的APV起源于右肺，2例（7%）起源于左肺，1例（4%）起源于双肺。在25例APV起源于右肺的患者中，9例APV汇入上腔静脉（SVC），13例汇入右心房（RA），1例汇入下腔静脉（IVC），2例汇入SVC和RA。在2例APV起源于左肺的患者中，1例APV汇入RA，另1例汇入无名静脉。APV起源于双肺的患者与IVC相连。23例（82%）患者有其他心血管缺陷。对13例肺/体循环血流比大于2.0的患者进行了手术。术后患者情况良好。7例患者在手术前我们无法准确确定APV的引流数量或部位。我们得出结论，选择性肺血管造影对于PAPVC的准确诊断必不可少。
