永存左上腔静脉(persistent left superior vena cava,PLSVC)是最常见的体循环静脉畸形,发生率约为0.3%~0.5%,占所有先天性心脏病的2.8%~4.3%,可以单独存在,也可合并其他心内外畸形。本组回顾性分析86例PLSVC胎儿及其合并畸形的相...永存左上腔静脉(persistent left superior vena cava,PLSVC)是最常见的体循环静脉畸形,发生率约为0.3%~0.5%,占所有先天性心脏病的2.8%~4.3%,可以单独存在,也可合并其他心内外畸形。本组回顾性分析86例PLSVC胎儿及其合并畸形的相关资料,总结PLSVC的声像图特征、伴发畸形及围产结局,旨在提高产前超声对该病的认识。展开更多
目的对孤立性永存左上腔静脉畸形(persistent left superior vena cava,PLSVC)的临床特点、自然病程及诊治经验进行系统性分析,以期减少临床漏诊率。方法采集、整理北京积水潭医院1例78岁孤立性PLSVC患者的症状体征演变史及其近21年历...目的对孤立性永存左上腔静脉畸形(persistent left superior vena cava,PLSVC)的临床特点、自然病程及诊治经验进行系统性分析,以期减少临床漏诊率。方法采集、整理北京积水潭医院1例78岁孤立性PLSVC患者的症状体征演变史及其近21年历次就诊的检查资料,进行比较分析。结果该例患者57岁出现心慌的首发症状,11年前因"病态窦房结综合征"安装双腔起搏器,术前检查外周血白细胞、血小板减低,术中发现PLSVC,7年前开始出现腹腔静脉淤血表现,5年前因重度三尖瓣反流、右心功能不全而就诊,3个月前胸部增强CT加血管重建明确为孤立性永存左上腔静脉畸形。结论孤立性永存左上腔静脉阳性症状出现晚,首发症状常为各种心律失常,临床极易漏诊误诊,心脏查体可于早期闻及三尖瓣收缩期杂音,超声心动图为首选筛查手段,心导管检查或增强CT加血管重建可明确诊断。其心律失常治疗包括起搏器植入术及冠状窦靶点消融。部分患者需早期手术治疗,疾病晚期可考虑心脏移植术。展开更多
<div style="text-align:justify;"> A persistent left superior vena cava (PLSVC) is a rare malformation which affects approximately 0.3<span>% </span><span>-</span><span> &l...<div style="text-align:justify;"> A persistent left superior vena cava (PLSVC) is a rare malformation which affects approximately 0.3<span>% </span><span>-</span><span> </span><span>0.5% of the population and it is presented along with a right-sided superior vena cava in 82.2% of the cases reported</span><span minion="" pro="" capt","serif";color:#943634;"="" style=""> </span><span minion="" pro="" capt","serif";color:#943634;background:yellow;"=""></span><span>[<a href="#ref1">1</a>]</span><span color:#943634;background:yellow;"=""></span><span minion="" pro="" capt","serif";color:#943634;background:yellow;"=""></span><span>.</span><span "=""><span> Clinicians diagnose it incidentally by difficulties with pacemaker implantation, central venous catheterization or screening for another etiologies when it is not accompanied by other anomalies it is typically asymptomatic. W. Schummer </span><i><span>et al.</span></i><span> described the embryogenesis and the anatomic variations of persistent LSVC according to the positioning of a central venous catheter on the chest radiograph: type I, normal;type II, only PLSVC;type IIIa, right and left superior vena cava with connection;type IIIb, right and left superior vena cava without connection</span></span><span> </span><span>[<a href="#ref2">2</a>]</span><span>. </span><span "=""><span>In 92% of individuals with PLSVC, the PLSVC drains into a dilated coronary sinus (CS) and rest 8% drain directly into the left atrium. PLSVC is caused by a failure in the closure of the left anterior cardinal vein during embryogenic development</span></span><span minion="" pro="" capt","serif";color:#943634;"=""><span> </span><span style="background:yellow;"></span></span><span color:#943634;"=""><span>[<a href="#ref3">3</a>]</span><span style="background:yellow;"></span></span><span minion="" pro="" capt","serif";color:#943634;background:yellow;"=""></span><span>. </span><span>The coronary sinus (CS) is a vein that transmits venous blood to the right atrium though atrioventricular groove. The CS wall contains atrial myocardium. Thus, it</span><span>s size</span><span> extensively depend</span><span>s</span><span> on variability of blood flow and pressure. We present a variant PLSVC with unknown prevalence and a mild </span><span>platypnea-orthodeoxia</span><span> </span><span>syndrome</span><span> after recovery of COVID-19 related acute respiratory distress syndrome (ARDS).</span> </div> <a href="#ref2"></a>展开更多
Purpose:Esophageal atresia is known to be associated with a variety of additi onal congenital anomalies in multiple organ systems.Emphasis on cardiovascular anomalies has been focused on aortic arch and intrinsic card...Purpose:Esophageal atresia is known to be associated with a variety of additi onal congenital anomalies in multiple organ systems.Emphasis on cardiovascular anomalies has been focused on aortic arch and intrinsic cardiac malformations.P ersistent left superior vena cava(PLSVC)is the most common venous thoracic ano maly in the general population and creates a problem when central venous access is required.This review was undertaken to define the incidence of PLSVC in infa nts with esophageal atresia and to determine if any subgroup of associated anoma lies poses additional risk.Methods:A retrospective,institutional review board-approved review of all children treated for esophageal atresia from 1993 to 20 02 at Riley Hospital for Children was undertaken.Of 118 children,89 had suffic ient data for inclusion.Charts were reviewed for gestational age,weight,type of atresia,echocardiogram,and associated anomalies.Statistical analysis was p erformed using the Fisher’s Exact test.Results:Of 89 children,8(9.9%;conf idence interval,4%-17%)had PLSVC compared with the reported incidence of 0.3%in the general population.Presence of additional organ system anomalies did not significantly increase relative risk for PLSVC.Conclusion:The incidence of PLSVC is significantly increased in children with esophageal atresia when compa red with the general population.This increased incidence of PLSVC is not influe nced by the presence of cardiac or other associated anomalies.This finding shou ld be kept in mind when central venous access is required in this patient popula tion.展开更多
左上腔静脉永存(permnnent left superior vena cava,PLSVC)即左锁骨下静脉与颈内静脉汇合后不与右侧无名静脉相融形成上腔静脉,而直接沿脊柱左缘下行在心脏后面与心脏静脉相融合形成巨大的冠状静脉窦,血液由此汇入右心房.孤立性的PLSV...左上腔静脉永存(permnnent left superior vena cava,PLSVC)即左锁骨下静脉与颈内静脉汇合后不与右侧无名静脉相融形成上腔静脉,而直接沿脊柱左缘下行在心脏后面与心脏静脉相融合形成巨大的冠状静脉窦,血液由此汇入右心房.孤立性的PLSVC对人体血流动力学并无影响,是良性的血管畸形,在正常人群中其发生率为0.5%[1].展开更多
永存左上腔静脉(persistent left superior vena cava,PLSVC)是胸腔内血管畸形的一种常见类型,因血管走形异常,伴或不伴右上腔静脉缺如等情况,在中心静脉插管操作过程中,以及经PLSVC留置导管透析过程中。常出现意想不到的并发症...永存左上腔静脉(persistent left superior vena cava,PLSVC)是胸腔内血管畸形的一种常见类型,因血管走形异常,伴或不伴右上腔静脉缺如等情况,在中心静脉插管操作过程中,以及经PLSVC留置导管透析过程中。常出现意想不到的并发症,给肾科医师带来困惑。本文分析2例维持性血液透析患者PLSVC的诊断过程,展开更多
文摘永存左上腔静脉(persistent left superior vena cava,PLSVC)是最常见的体循环静脉畸形,发生率约为0.3%~0.5%,占所有先天性心脏病的2.8%~4.3%,可以单独存在,也可合并其他心内外畸形。本组回顾性分析86例PLSVC胎儿及其合并畸形的相关资料,总结PLSVC的声像图特征、伴发畸形及围产结局,旨在提高产前超声对该病的认识。
文摘目的对孤立性永存左上腔静脉畸形(persistent left superior vena cava,PLSVC)的临床特点、自然病程及诊治经验进行系统性分析,以期减少临床漏诊率。方法采集、整理北京积水潭医院1例78岁孤立性PLSVC患者的症状体征演变史及其近21年历次就诊的检查资料,进行比较分析。结果该例患者57岁出现心慌的首发症状,11年前因"病态窦房结综合征"安装双腔起搏器,术前检查外周血白细胞、血小板减低,术中发现PLSVC,7年前开始出现腹腔静脉淤血表现,5年前因重度三尖瓣反流、右心功能不全而就诊,3个月前胸部增强CT加血管重建明确为孤立性永存左上腔静脉畸形。结论孤立性永存左上腔静脉阳性症状出现晚,首发症状常为各种心律失常,临床极易漏诊误诊,心脏查体可于早期闻及三尖瓣收缩期杂音,超声心动图为首选筛查手段,心导管检查或增强CT加血管重建可明确诊断。其心律失常治疗包括起搏器植入术及冠状窦靶点消融。部分患者需早期手术治疗,疾病晚期可考虑心脏移植术。
文摘<div style="text-align:justify;"> A persistent left superior vena cava (PLSVC) is a rare malformation which affects approximately 0.3<span>% </span><span>-</span><span> </span><span>0.5% of the population and it is presented along with a right-sided superior vena cava in 82.2% of the cases reported</span><span minion="" pro="" capt","serif";color:#943634;"="" style=""> </span><span minion="" pro="" capt","serif";color:#943634;background:yellow;"=""></span><span>[<a href="#ref1">1</a>]</span><span color:#943634;background:yellow;"=""></span><span minion="" pro="" capt","serif";color:#943634;background:yellow;"=""></span><span>.</span><span "=""><span> Clinicians diagnose it incidentally by difficulties with pacemaker implantation, central venous catheterization or screening for another etiologies when it is not accompanied by other anomalies it is typically asymptomatic. W. Schummer </span><i><span>et al.</span></i><span> described the embryogenesis and the anatomic variations of persistent LSVC according to the positioning of a central venous catheter on the chest radiograph: type I, normal;type II, only PLSVC;type IIIa, right and left superior vena cava with connection;type IIIb, right and left superior vena cava without connection</span></span><span> </span><span>[<a href="#ref2">2</a>]</span><span>. </span><span "=""><span>In 92% of individuals with PLSVC, the PLSVC drains into a dilated coronary sinus (CS) and rest 8% drain directly into the left atrium. PLSVC is caused by a failure in the closure of the left anterior cardinal vein during embryogenic development</span></span><span minion="" pro="" capt","serif";color:#943634;"=""><span> </span><span style="background:yellow;"></span></span><span color:#943634;"=""><span>[<a href="#ref3">3</a>]</span><span style="background:yellow;"></span></span><span minion="" pro="" capt","serif";color:#943634;background:yellow;"=""></span><span>. </span><span>The coronary sinus (CS) is a vein that transmits venous blood to the right atrium though atrioventricular groove. The CS wall contains atrial myocardium. Thus, it</span><span>s size</span><span> extensively depend</span><span>s</span><span> on variability of blood flow and pressure. We present a variant PLSVC with unknown prevalence and a mild </span><span>platypnea-orthodeoxia</span><span> </span><span>syndrome</span><span> after recovery of COVID-19 related acute respiratory distress syndrome (ARDS).</span> </div> <a href="#ref2"></a>
文摘Purpose:Esophageal atresia is known to be associated with a variety of additi onal congenital anomalies in multiple organ systems.Emphasis on cardiovascular anomalies has been focused on aortic arch and intrinsic cardiac malformations.P ersistent left superior vena cava(PLSVC)is the most common venous thoracic ano maly in the general population and creates a problem when central venous access is required.This review was undertaken to define the incidence of PLSVC in infa nts with esophageal atresia and to determine if any subgroup of associated anoma lies poses additional risk.Methods:A retrospective,institutional review board-approved review of all children treated for esophageal atresia from 1993 to 20 02 at Riley Hospital for Children was undertaken.Of 118 children,89 had suffic ient data for inclusion.Charts were reviewed for gestational age,weight,type of atresia,echocardiogram,and associated anomalies.Statistical analysis was p erformed using the Fisher’s Exact test.Results:Of 89 children,8(9.9%;conf idence interval,4%-17%)had PLSVC compared with the reported incidence of 0.3%in the general population.Presence of additional organ system anomalies did not significantly increase relative risk for PLSVC.Conclusion:The incidence of PLSVC is significantly increased in children with esophageal atresia when compa red with the general population.This increased incidence of PLSVC is not influe nced by the presence of cardiac or other associated anomalies.This finding shou ld be kept in mind when central venous access is required in this patient popula tion.
文摘左上腔静脉永存(permnnent left superior vena cava,PLSVC)即左锁骨下静脉与颈内静脉汇合后不与右侧无名静脉相融形成上腔静脉,而直接沿脊柱左缘下行在心脏后面与心脏静脉相融合形成巨大的冠状静脉窦,血液由此汇入右心房.孤立性的PLSVC对人体血流动力学并无影响,是良性的血管畸形,在正常人群中其发生率为0.5%[1].
文摘永存左上腔静脉(persistent left superior vena cava,PLSVC)是胸腔内血管畸形的一种常见类型,因血管走形异常,伴或不伴右上腔静脉缺如等情况,在中心静脉插管操作过程中,以及经PLSVC留置导管透析过程中。常出现意想不到的并发症,给肾科医师带来困惑。本文分析2例维持性血液透析患者PLSVC的诊断过程,