Brown V E, De Lange M, Dyar D A, Impastato L W, Shirali G S
Loma Linda University Children's Hospital, CA 92354, USA.
J Am Soc Echocardiogr. 1998 Mar;11(3):289-93. doi: 10.1016/s0894-7317(98)70091-4.
Although infracardiac total anomalous pulmonary venous connection (TAPVC) is almost always associated with venous obstruction, the incidence and location of obstruction in supracardiac TAPVC has not been completely delineated. This report summarizes our experience with 20 cases of supracardiac TAPVC diagnosed by transthoracic echocardiography from Jan. 1989 to Mar. 1997. Fifty percent were obstructed, and five different sites of narrowing were found. The most common sites of obstruction were at the level of the left pulmonary artery (left vertical vein) and at the insertion into the superior vena cava (right vertical vein). Because nonobstructed Doppler flow patterns are present proximal to the actual site of obstruction in the anomalous pathway, a thorough interrogation of the entire venous channel with two-dimensional and Doppler echocardiography is essential to provide complete preoperative anatomic and hemodynamic details to determine the nature and timing of surgery in this condition.
尽管心内型完全性肺静脉异位连接（TAPVC）几乎总是伴有静脉梗阻，但心上型TAPVC梗阻的发生率及部位尚未完全明确。本报告总结了我们自1989年1月至1997年3月经胸超声心动图诊断的20例心上型TAPVC的经验。其中50%存在梗阻，发现了5个不同的狭窄部位。最常见的梗阻部位是左肺动脉水平（左垂直静脉）以及汇入上腔静脉处（右垂直静脉）。由于在异常路径中梗阻实际部位近端存在无梗阻的多普勒血流模式，因此运用二维和多普勒超声心动图对整个静脉通道进行全面检查，对于术前提供完整的解剖和血流动力学细节以确定该病的手术性质和时机至关重要。
