在心房 Septal 缺陷关闭后发生了 Iatrogenic 右向左移动的病例
Naohiko Oki1, Naritaka Kimura1, Hideaki Shimizu1
1Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan.
Surgical case reports
|September 17, 2025
概括
一个心房隔膜缺陷 (ASD) 修复并发症导致一个无意的下腔静脉 (IVC) 到左心脏 (LA) 连接,导致右到左的分流 (RLS). 外科医生必须在ASD修复过程中仔细识别结构,以防止这种阳性缺陷.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 医学案例报告 病例报告
背景情况:
- 在心房隔膜缺陷 (ASD) 中,右向左的分流 (RLS) 通常是由肺高血压或其他心脏异常引起的.
- 在ASD修复后,下腔静脉 (IVC) 和左心房 (LA) 之间的阳性连接非常罕见.
研究的目的:
- 在ASD修复后报告一种罕见的因无意的IVC-LA连接引起的阳性RLS病例.
- 为了强调细致的外科技术在ASD关闭中的重要性.
主要方法:
- 一名47岁的男性有先前的ASD修复史,呈现出色和RLS.
- 诊断工作包括过食道心声学,心脏CT和心脏导管.
- 该患者成功地通过手术纠正了阳性IVC-LA连接和残留的ASD.
主要成果:
- 确定了IVC和LA之间的直接联系,以及残留的ASD,导致显著的RLS.
- 患者在初始修复后,与症状共存了大约40年.
- 成功的手术修复恢复了正常的心内血流.
结论:
- 在ASD修复过程中,由于错误识别结构,例如欧斯塔基门,Iatrogenic RLS可能会发生.
- 外科医生必须非常谨慎,并仔细评估心内解剖学,以防止意外连接.
- 正确识别和维护静脉结构对于成功关闭ASD至关重要.
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