摘要
本文报告１９０２９例先天性心脏心内直视手术中合并永存左上腔静脉（ＰＬＳＶＣ）３２６例（１．７１％）的诊断及术中处理。其中以单心房（２７．５０％）和完全性心内膜垫缺损（９．６２％）的发生率较高，而以肺动脉瓣狭窄或法乐三联症的发生率较低（０．４８％），ＰＬＳＶＣ入右房２９０例（８８．９５％），ＰＬＳＶＣ入左房３６例（１１．０４％）。术前ＰＬＳＶＣ的诊断率为３３．１２％。术后死亡５２例。作者认为，ＰＬＳＶＣ畸形在先天性心脏病中并非少见，而ＰＬＳＶＣ的许多特殊问题逐步被人们所重视。本文就ＰＬＳＶＣ的漏诊原因、术中对ＰＬＳＶＣ的不同处理方法等进行了讨论。
Nineteen thousand and twenty nine patients with congenital heart diseases CHD had intracardiac operation in our hospital from 1957 to 1993.Among them,three hundred and twenty six patients were associated with persistent left superior vena cava(PLSVC).With an incidence of 1.71%.PLSVC was more commonly associated with single atrium(27.5%) and complete A-V canal defect(9.62%),but rarely with pulmonary stenosis(0.48%).PLSVC drained into the right atrium in 290 cases (88.95%),into the left atrium in 36 cases(11.04%).The right superior vena cava was absent in 9cases.The rate of preoperative diagnosis of PLSVC was only 33.12%.During operation,the management was as follows:①PLSVC→RA group:temporary occlusion in 164 cases;direct cannulation through PLSVC in 89 cases;pump sucking in 14 cases;total circulatory arrest in 17 cases;ligation of this vessel in 2 cases;② PLSVC→LA group:ligation in 13 cases;baffle patch in 18 cases;tunnel repair in 2 cases;vessel by pass in 1 case;no management in 2 cases.The postoperative mortality was 15.95%(52/326).The incidence of PLSVC was more common in CHD in our series, but the preoperative diagnosis was very poor.If the existence of PLSVC is not suspected before operation,serious operative difficulties may be encountered in many cases especially in those with PLSVC →LA.There are different operative methods to deal with this vessel,but better method should be selected according to the location of this vessel and surgical procedure.
出处
《中国循环杂志》
CSCD
1995年第10期603-606,共4页
Chinese Circulation Journal
