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左側上 空靜脈遺殘症 : 4例報告 Report of 4 Cases
李寧均,具蒼水,徐景弼,金升煥 中央醫學社 1964 中央醫學 Vol.7 No.2
Four cases of double superior vena cava were noted among 70 congenital cardiac malformation patients who were operated on in this departrment during the past five years. The first case was associated with ventricular septal defect, the second with tetralogy of Fallot, the third with Levocardia accompanied by complete transposition of the great vessels and pulmonary stenosis, and the last with patent ductus arteriosus. The persistence of the left superoir vena cava was confirmed by cardiac catheterization, vena-cavogram, and direct vision during operation. During this period 23 patent ductus arteriosus, 28 tetralogy of Fallot, and 5 cases of ventricular septal defect were operated on in the department. Each case had right sided superior vena cava in addition to the left one, i.e. double superior venae cavae.
李寧均,朴鍾善,崔秉茂,金升煥,洪彰義,姜錫麟 中央醫學社 1963 中央醫學 Vol.5 No.5
A six years old Korean girl was admitted in February 1963, with cyanotic congenital heart disease. By auscultation grade I -Ⅱ systolic murmur was audible along the left sternal border without thrill. Remarkable laboratory findings were high degree of and hematuria, polycythemia, albuminuria, and right sided hemiparesis. Transposition of the abdominal viscera with levocardia was found on routine X-ray study ECG showed right axis deviation and inverted P-wave in lead I . The right heart catheterization and angiocardiography with Shonander serial X-ray machine showed the right-sided (venous)atrium receiving the right and left superior vena cava separately, complete transposition of the great vessels, shunt at the ventricular level, and pulmonary stenosis. The inferior vena cava coursed along the left border of the spinal column and drained into the venous atrium, which is in the left hemithorax. The aortic arch was left-sided and bifurcated right ureter was visualized. Glenn' s procedure was done to increase the pulmonary blood flow in March 1963. Postoperative course was benign and uneventful. The follow-up study of the case, five month postively, revealed satisfactory results; increased exercise tolerance, marked relief from dyspnea on exertion, abolished cyanosis on rest, incresed arterial oxygen saturation (from 48% to 70%), normalization of hemogram, and increased pulmonary vascularity on the right lung field. The final anatomical findings of this unusually complicated cardiac anomaly were: (1) Levocardia with situs inversus viscerum, chamber inversion, and inverted P-wave in Lead I on ECG. (2) Transposition of the great vessels with pulmonary stenosis. (3) Intra-cardiac shunt or Shunts: i. Undetermined intracardiac shunt, Vntricular septal defect or single vent -ricle or atrioventricularis communis ? ii. Confirmed atrial septal defect. (4) Double superior vena cavae: left superior vena cava drained into the right atrial cavity (right atrium proper or coronary sinus?). Inferior vena cava on the left side. (By course of the cardiac catheter) Left aortic arch and left descending aorta. Bifurcated right ureter. Asplenia :presence not determined. Three lobes of the right lung confirmed by operation but numbr of lobes on the left lung undetermined. This report is believed to be the first operative palliation case of complete trans-position of the great vessels with pulmonary stenosis in a Korean literature.