不寻常的左上静脉卡瓦,通过左上肺静脉连接到左心室
Abdelkader Boukhmis1, Mohamed El-Amin Nouar1
1Department of Cardiac Surgery, University Hospital Center MUSTAPHA, Algiers, Algeria.
Archives of Iranian medicine
|August 5, 2023
概括
持续的左上 vena cava (LSVC) 异常可以通过在心肺绕道过程中引起气栓塞使心脏手术复杂化. 早期识别和绑定LSVC对于患者的安全至关重要.
科学领域:
- 心血管外科心血管外科
- 解剖学上的异常
- 医学案例报告 病例报告
背景情况:
- 持续的左上静脉腔 (LSVC) 是一种罕见的异常,系统静脉血液流入左心室.
- 未被诊断的LSVC可能会导致心肺绕道术 (CPB) 期间的阴光症,复发性中风和显著的手术内并发症.
- 由于LSVC的外皮心脏过程,通常会使手术内识别具有挑战性.
研究的目的:
- 报告一个LSVC病例,并复杂化了米特拉和大动脉内心炎手术.
- 突出LSVC在CPB期间所带来的诊断和管理挑战.
- 强调识别和解决LSVC的重要性,以确保外科安全.
主要方法:
- 一个48岁的男性患者的病例报告,患有内心炎和Laubry-Pezzi综合征.
- 在CPB期间通过意外的气栓塞和静脉洪水进行LSVC的内科诊断.
- 手术管理涉及外皮心外 LSVC 的暴露,临时紧和绑定.
- 执行 mitra 门修复,大动脉门更换,隔膜缺陷关闭和三管取消术.
主要成果:
- 患者在CPB期间经历了突然的气锁和静脉洪水,这是由于未被诊断的LSVC流入左前庭.
- 由于LSVC的心脏外流程,需要打开左侧膜以进行识别和管理.
- 通过手术成功地纠正了LSVC和心脏门病理.
- 患者在经过手术10天后出院,病情稳定.
结论:
- 持续的左上 vena cava 在心脏手术期间存在重大风险,特别是在CPB.
- 早期识别和治疗LSVC,包括其心外循环,对于预防危及生命的并发症至关重要.
- 结合LSVC是一种安全有效的方法,用于在心脏手术期间管理这种异常.
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