19例左上腔静脉引流入左心房的诊治  

Diagnostic methods and surgical treatment of the left superior vena cava draining into the left atrium

作　　者：李磊[1] 范祥明[1] 吴永涛[1] 朱耀斌[1] 陈哲[1] 苏俊[1] 武程沛[1] 刘迎龙[1] 

机构地区：[1]首都医科大学附属北京安贞医院小儿心脏外科,100029

出　　处：《中华胸心血管外科杂志》2012年第7期412-414,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：北京市自然科学基金（7112046）

摘　　要：目的总结左上腔静脉引流入左心房的诊治体会。方法1998年2月至2012年1月收治19例先天性心脏病合并左上腔静脉引流人左心房患儿，男10例，女9例，年龄0．5—12．0岁；体重6～28kg。均经心脏彩色多普勒、左上肢声学造影及心导管心室造影、CT等检查明确诊断。采用直接结扎或切断缝合、自体心包左心房内隧道、房间隔重建、双向Glenn手术治疗。结果全组病例无死亡。术后恢复过程平稳。术后随访，最长者已11年，情况良好。结论左上腔静脉引流入左心房术前确诊较难，加深对其特性的认识可以提高术前检出率，手术治疗效果良好。Objective To review our experiences of diagnostic methods and surgical treatment of the left superior vena cava（LSVC） draining into the left atrium. Methods Nineteen patients with LSVC draining into the left atrium were diagnosed and treated surgically from February 1998 to January 2012. All the cases were combined with other congenital heart diseases in- cluding patent ductus arteriosus, ventricular septal defect, atrial septal defect, single atrium, triatriatum, partial endocardial cushion defect, anomalous pulmonary venous drainage, fight ventricle outflow stenosis, pulmonary valve stenosis, tetralogy of Fallot, double outlet fight ventricle, complete endoeardial cushion defect, tricuspid atresia. The patients were diagnosed through different methods including echocardiographic examination, cardiac catheterization, computer tomography, and ex- plored during the operation, even postoperatively. All were treated surgically with four techniques including simple ligation to the LSVC, including ligation during a redo procedure; intra atrial rerouting to drainage the flow from the LSVC to the fight atri- um, atrial septum reconst^ction to make the outlet of the LSVC lying in the fight side of the patched atrial septal, and bidirec- tional Glenn shunt to get a physiological result. Results No mortality postoperatively. All the cases were uneventful postopera- tively. And the main postoperative course was related only to the main diagnosis of congenital heart disease, not to the left supe- rior vena cava draining into the left atrium. The echo examination result was satisfied before the discharge. The early and long term follow-up（ 1 - 11 years）results are excellent, no arrhythmia, no cardiac deficits Mter echo examination ,including steno- sis obstruction and residual shunt. No death. Conclusion The diagnostic methods of the LSVC draining into the left atrium are difficuh, the only way to make the diagnosis clearly enough betore the operation is depending on improving of more and more comprehending to this ra

关 键 词：心脏缺损 先天性 左上腔静脉 左心房 体静脉异位引流 诊断 心脏 外科手术 

分 类 号：R726.5[医药卫生—儿科]