心脏静脉先天性异常连接的外科治疗

Surgical Treatment of Anomalous Congenital Connection of Cardiac Veins

目的通过探讨心脏静脉异常连接的种类、手术方式及其结果来总结经验教训。方法本文回顾性分析本科近30年的手术病例中有关心脏静脉异常连接的76份病例,按心脏术中发现的静脉异常连接的种类进行统计分析。结果部分肺静脉异位引流37例,34例痊愈;完全性肺静脉异位引流16例,12例痊愈;完全性腔静脉异位引流2例,无死亡;双上腔静脉16例,10例痊愈;下腔静脉回流异常5例,4例痊愈。结论心脏静脉异常连接种类繁多,术前充分了解、术中探查对术中的处理有帮助。完全性肺静脉异位引流与双上腔静脉常与其他畸形尤其是复杂心脏畸形合并存在,处理不能遗忘。完全性腔静脉异位引流入左房为临床中罕见病例,超高速CT对诊断帮助最大。

Objective To summarize the kinds of cardiac anomalous veins connection, surgical styles and their results, then, try to find out success and failure experiences. Methods This paper retrospectively analysis 76 cardiac anomalous veins connection cases that were our department operated on in 30 years. Statistical analyses were according to the kinds of cardiac anomalous vein connection, which find in surgical procedures. Results Part anomalous pulmonary vein drains were 37 cases and 34 cases were cured. Total anomalous pulmonary vein drains were 16 cases and 12 cases were cured. Total anomalous cava drains were 2 cases and none of them died. Double superior vena cava was 16 cases and 10 cases were cured. Anomalous inferior vena cava 5 cases and 4 of them were cured. Conclusion There are a lot of kinds of anomalous cardiac venous connection. Full comprehends before operation and attentive exploration during operation is helpful to treatment of disease. Total anomalous pulmonary venous drains and double superior vena cava usually combine with other malformations, especially with complex heart malformation and can not forget in operation. Total anomalous cava drain is rare in clinic. UFCT may most helpful in their diagnoses.