Complete superior vena cava obstruction.
Complete superior vena cava obstruction.
复制标题
上腔静脉完全阻塞。
DOI：
10.1016/j.jacc.2009.09.074
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发表时间：
2010
影响因子：
24
通讯作者：
Rottman,JeffreyN
中科院分区：
文献类型：
--
作者：
Raj,SatishR;Dendy,JeffreyM;Rottman,JeffreyN
进行磁共振静脉造影是为了更好地了解起搏器植入失败的女性的静脉解剖结构。与健康受试者 (A) 相比，她的最大强度投影图像 (B) 显示上腔静脉缺失（SVC [箭头]）。尽管保留了双侧右锁骨下动脉（RSA）和左锁骨下动脉（LSA），但右锁骨下静脉（RSV）和左锁骨下静脉（LSV）缺失。上半身侧支引流通过椎旁静脉、奇静脉和扩大的肋间静脉 (*) 发生，类似于主动脉缩窄时出现的动脉“肋骨切迹”(B)。磁共振成像 3 维重建（健康受试者 [C，在线视频 1] 和患者 [D，在线视频 2]）显示扭曲的静脉解剖结构。除了充血的肋间静脉（IC）外，我们的患者还有“裸露”的主动脉（Ao），没有叠加的SVC和右头臂静脉（RBV）和左头臂静脉（LBV）。通过髂股静脉成功植入心脏再同步系统。随着经皮介入治疗的增加，心脏病专家将来可能会遇到类似的解剖结构。
Magnetic resonance venography was performed to better understand venous anatomy in a woman with failed pacemaker implantation. Compared with a healthy subject (A), her maximal intensity projection images (B) showed an absent superior vena cava (SVC [arrowhead]). The right subclavian vein (RSV) and left subclavian vein (LSV) were absent, although bilateral right subclavian arteries (RSA) and left subclavian arteries (LSA) were preserved. Upper body collateral drainage occurred though paravertebral veins, the azygous vein, and enlarged intercostal veins (*), appearing similar to arterial “rib notching” that is seen with aortic coarctation (B). Magnetic resonance imaging 3-dimensional reconstructions (healthy subject [C, Online Video 1] and patient [D, Online Video 2]) show the distorted venous anatomy. In addition to engorged intercostal veins (IC), our patient has a “bare” aorta (Ao), without superimposed SVC and right brachiocephalic vein (RBV) and left brachiocephalic vein (LBV). A cardiac resynchronization system was successfully implanted through an iliofemoral vein. With increased percutaneous interventions, cardiologists will likely confront similar anatomy in the future.