复杂先天性心脏病术后残余左上腔静脉异位引流入左心房介入治疗1例  

A case of postoperative residual left superior vena cava ectopic drainage into the left atrium after surgery for complex congenital heart disease

作　　者：栗政伟 胡海波[1] 吕建华[1] 潘湘斌[1] LI Zheng-wei;HU Hai-bo;LÜJian-hua;PAN Xiang-bin(Center of Structural Heart Disease,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100037,China)

机构地区：[1]国家心血管病中心、北京协和医学院、中国医学科学院阜外医院结构性心脏病中心,北京100037

出　　处：《中国介入心脏病学杂志》2024年第5期298-300,共3页Chinese Journal of Interventional Cardiology

基　　金：北京市科学技术委员会“首都临床特色诊疗技术研究与转化应用”专项基金项目(Z201100005520075)。

摘　　要：永存左上腔静脉(PLSVC)是一种较常见的先天性体静脉畸形,常常回流入右心房,无需特殊处理。PLSVC回流入左心房,形成右向左分流,导致血氧饱和度降低及矛盾栓塞,需要对其进行处理。传统外科手术结扎PLSVC是常规处理异常分流的方法,但创伤比较大,且具有损伤膈神经的风险。本病例报道介绍了1例因复杂先天性心脏病矫治术遗漏PLSVC-左心房交通未处理,术后产生左向右分流,导致右心功能不全的患者,采用国产Plug血管塞经房间隔入路成功介入封堵PLSVC。本病例报道经房间隔入路成功封堵复杂先天性心脏病矫治术后PLSVC-左心房通道伴左向右分流,表明介入封堵是这类疾病比较理想的处理方式。Persistent lef t superior vena cava(PLSVC)is a common congenital anomaly of systemic venous drainage,often draining into the right atrium without the need for special treatment.Sometimes,PLSVC drains into the left atrium,creating a right-to-left shunt,leading to reduced blood oxygen saturation and paradoxical embolism,requiring intervention.Traditional surgical ligation of PLSVC is the conventional approach for managing abnormal shunting,but it is associated with significant trauma and carries the risk of damaging the phrenic nerve.Here,we present a case of a patient with right heart dysfunction due to an untreated PLSVC-left atrium communication after corrective surgery for complex congenital heart disease,resulting in left-to-right shunting postoperatively.The patient was successfully treated by using a Plug vascular occluder via a transseptal approach to occlude the PLSVC.To our knowledge,this is the first report of successful closure of the left-to-right shunting through the heart chambers via a transseptal approach,indicating that interventional occlusion is an ideal management approach.

关 键 词：永存左上腔静脉 经房间隔入路 左向右分流 介入封堵 

分 类 号：R541[医药卫生—心血管疾病]