■下腔静脉(IVC)异常引流到左心房(LA)是成人紫癜的罕见病因。这种情况可能与房间隔缺损有关,肺静脉引流异常,和肺动静脉瘘.此病例报告提供了一个IVC异常引流到LA的实例,与窦口继发孔型房间隔缺损(ASD)相关。它通过强调与这种异常相关的诊断挑战,为现有文献做出了贡献。特别是在外科手术期间。
■一名38岁男性,有6年劳力性呼吸困难和阵发性心悸病史。经胸超声心动图显示有一个大的secundum(ASD),IVC排入洛杉矶,左侧上腔静脉,轻度二尖瓣反流.通过左右心导管插入术和CT血管造影进一步证实了这些发现。患者被转诊至CTVS部门进行手术矫正。术后过程顺利。在1.4年的随访中,患者报告症状明显改善.
■我们介绍了IVC异常排入LA的情况,与窦口ASD有关。在~70%的报告病例中,ASD与这种情况同时发生。这种异常不同于低腔或下腔静脉闭孔ASD,突出的咽鼓管瓣膜会导致血液从IVC分流到LA。如果外科医生不警惕,这可能被误认为是下ASD边缘,ASD关闭后可能导致医源性IVC血液转移到LA,导致紫癜。该病例强调了与该病症相关的诊断和手术挑战。
UNASSIGNED: Anomalous drainage of inferior vena cava (IVC) into left atrium (LA) is a rare aetiology of cyanosis in adults. This condition may be associated with atrial septal defects, anomalous pulmonary venous drainage, and pulmonary arteriovenous fistulas. This
case report presents an instance of anomalous drainage of IVC into LA, associated with ostium secundum atrial septal defect (ASD). It contributes to the existing literature by highlighting the diagnostic challenges associated with this anomaly, particularly during surgical intervention.
UNASSIGNED: A 38-year-old male presented with a six-year history of exertional dyspnoea and episodic palpitation. Transthoracic echocardiography revealed a large secundum (ASD), the IVC draining into LA, a left superior vena cava, and mild mitral regurgitation. These findings were further confirmed by right and left heart catheterization and CT angiogram. The patient was referred to CTVS department for surgical correction. The post-operative course was uneventful. At a 1.4-year follow-up, the patient reported significant improvement in symptoms.
UNASSIGNED: We present a
case of anomalous drainage of IVC into LA, associated with ostium secundum ASD. An ASD co-occurs with this condition in ∼70% of the reported cases. This anomaly differs from a low or inferior vena caval secundum ASD, where a prominent Eustachian valve can cause blood shunting from the IVC to LA. If the surgeon is not vigilant, this can be mistaken for the inferior ASD rim, potentially leading to iatrogenic diversion of IVC blood to LA upon ASD closure, resulting in cyanosis. This
case underscores the diagnostic and surgical challenges associated with this condition.