Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Low Cardiac Output after Division of the Left Superior Vena Cava during a Norwood Operation for Hypoplastic Left Heart Syndrome in a Patient with Coronary Sinus Orifice Atresia -A case report-

관상정맥동 유입부 폐쇄를 동반한 좌심형성부전 증후군 환자의 Norwood 수술 중 좌상대정맥 절단 후 발생한 저박출증 - 1예 보고 -

  • Choi, Eun-Seok (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Kim, Woong-Han (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Park, Sung-Joon (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Kwak, Jae-Gun (Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital) ;
  • Seo, Jeong-Wook (Department of Pathology, Seoul National University Hospital)
  • 최은석 (서울대학교병원 흉부외과) ;
  • 김웅한 (서울대학교병원 흉부외과) ;
  • 박성준 (서울대학교병원 흉부외과) ;
  • 곽재건 (부천세종병원 흉부외과) ;
  • 서정욱 (서울대학교병원 병리과)
  • Received : 2009.07.30
  • Accepted : 2009.12.18
  • Published : 2010.04.05
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Abstract

A 12-day-old female baby underwent a Norwood procedure for hypoplastic left heart syndrome. The left superior vena cava (LSVC), which was found incidentally during the operation, was divided to facilitate surgical exposure. After the operation, she developed signs of low cardiac output and died 7 hours afterward. Autopsy findings showed that the coronary sinus was atretic at the orifice without unroofing into both atria, rendering the LSVC the sole route of coronary sinus drainage. In patients with incidentally-found LSVC during surgery, special care should be taken to leave the LSVC intact because the LSVC may be the exclusive drainage vein of the coronary venous system.

좌심형성부전 증후군을 진단 받은 여자 아이가 생후 12일에 Norwood 수술을 받았다. 수술 중 우연히 발견된 좌상대정맥은 수술 시야를 확보하기 위해 절단하였다. 수술 후 점진적인 저박출증을 보인 환아는 수술 후 7시간 째 사망하였다. 부검 결과 관상정맥동 유입부가 폐쇄되어 있고, 관상정맥동과 심방 사이에 교통이 없었으며, 좌상대정맥이 관상정맥동 혈류의 유일한 통로였다. 수술 중 우연히 좌상대정맥이 발견된 환자에서, 좌상대정맥이 심장 정맥혈류의 유일한 통로일 수 있으므로 좌상대정맥을 보존해야 한다.

Keywords

References

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Cited by

  1. Management of Coronary Sinus Ostial Atresia during a Staged Operation of a Functional Single Ventricle vol.51, pp.2, 2010, https://doi.org/10.5090/kjtcs.2018.51.2.130