部分肺静脈還流異常症 partial anomalous pulmonary venous connection
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出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2015/02/13 22:31:45」(JST)
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Scimitar syndrome |
Chest MR angiography in a patient with scimitar syndrome
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Classification and external resources |
ICD-10 |
Q26.8 |
ICD-9 |
747.49 |
NCI |
Scimitar syndrome |
MeSH |
D012587 |
Scimitar syndrome, or pulmonary venolobar syndrome, is a rare congenital heart defect characterized by anomalous venous return from the right lung (to the systemic venous drainage, rather than directly to the left atrium).[1] This anomalous pulmonary venous return can be either partial (PAPVR) or total (TAPVR). The syndrome associated with PAPVR is more commonly known as Scimitar syndrome after the curvilinear pattern created on a chest radiograph by the pulmonary veins that drain to the inferior vena cava.[2] This radiographic density often has the shape of a scimitar, a type of curved sword.[2]
Contents
- 1 Presentation
- 2 Diagnosis
- 3 Treatment
- 4 References
- 5 External links
- 6 Further reading
Presentation
Chest x-ray of a five-year-old girl with Scimitar syndrome. The heart (blue outline) is shifted into the right half of the chest, and the anomalous pulmonary venous return (red) has a shape reminiscent of a Scimitar.
The anomalous venous return forms a curved shadow on chest x-ray such that it resembles a scimitar. This is called the Scimitar Sign. Associated abnormalities include right lung hypoplasia with associated ()dextroposition of the heart, pulmonary artery hypoplasia and pulmonary sequestration.
Diagnosis
The diagnosis is made by transthoracic or transesophageal echocardiography, angiography, and more recently by CT angiography or MR Angiography.
Treatment
Surgical correction should be considered in the presence of significant left to right shunting (Qp:Qs ≥ 2:1) and pulmonary hypertension. This involves creation of an inter-atrial baffle to redirect the pulmonary venous return into the left atrium. Alternatively, the anomalous vein can be re-implanted directly into the left atrium.
References
- ^ Sehgal, Arvind; Loughran-Fowlds, Allison, Clinical Brief: Scimitar Syndrome (PDF), medIND — Biomedical journals from India, retrieved 2008-02-28
- ^ a b Scimitar Syndrome, Children's Hospital Boston, retrieved 2008-02-28
External links
- Holt, PD; Berdon, WE; Marans, Z; Griffiths, S; Hsu, D (February 2004). "Scimitar vein draining to the left atrium and a historical review of the scimitar syndrome". Pediatric Radiology 34 (5): 409–13. doi:10.1007/s00247-004-1149-0. PMID 14872299.
Further reading
- A case of Scimitar Syndrome
- Halasz NA, Halloran KH, Liebow AA (November 1956). "Bronchial and arterial anomalies with drainage of the right lung into the inferior vena cava". Circulation 14 (5): 826–46. doi:10.1161/01.cir.14.5.826. PMID 13374858.
- Kramer U, Dörnberger V, Fenchel M, Stauder N, Claussen CD, Miller S (December 2003). "Scimitar syndrome: morphological diagnosis and assessment of hemodynamic significance by magnetic resonance imaging". Eur Radiol 13 (Suppl 4): L147–50. doi:10.1007/s00330-003-2061-y. PMID 15018181.
- Brown JW, Ruzmetov M, Minnich DJ, et al. (February 2003). "Surgical management of scimitar syndrome: an alternative approach". J. Thorac. Cardiovasc. Surg. 125 (2): 238–45. doi:10.1067/mtc.2003.113. PMID 12579091.
Congenital vascular defects / Vascular malformation (Q25–Q28, 747)
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Great arteries/
other arteries |
Aorta
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- Patent ductus arteriosus
- Coarctation of the aorta
- Interrupted aortic arch
- Double aortic arch
- Right-sided aortic arch
- Overriding aorta
- Aneurysm of sinus of Valsalva
- Vascular ring
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Pulmonary artery
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- Pulmonary atresia
- Stenosis of pulmonary artery
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Subclavian artery
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- Aberrant subclavian artery
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Umbilical artery
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Great veins |
Superior/inferior vena cava
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- Congenital stenosis of vena cava
- Persistent left superior vena cava
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Pulmonary vein
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- Anomalous pulmonary venous connection (Total, Partial)
- Scimitar syndrome
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Arteriovenous malformation |
- Cerebral arteriovenous malformation
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Index of the circulatory system
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Description |
- Anatomy
- Arteries
- head and neck
- arms
- chest
- abdomen
- legs
- Veins
- head and neck
- arms
- chest
- abdomen and pelvis
- legs
- Development
- Cells
- Physiology
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Disease |
- Congenital
- Neoplasms and cancer
- Lymphatic vessels
- Injury
- Vasculitis
- Other
- Symptoms and signs
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Treatment |
- Procedures
- Drugs
- beta blockers
- channel blockers
- diuretics
- nonsympatholytic vasodilatory antihypertensives
- peripheral vasodilators
- renin–angiotensin system
- sympatholytic antihypertensives
- vasoprotectives
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UpToDate Contents
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English Journal
- [Life threatening haemoptysis associated with partial abnormal pulmonary venous return and pulmonary arterial hypertension.]
- Pricopi C1, Debagh H2, Hernigou A3, Arame A2, Riquet M2.
- Revue de pneumologie clinique.Rev Pneumol Clin.2015 Feb 26. pii: S0761-8417(15)00008-5. doi: 10.1016/j.pneumo.2014.12.005. [Epub ahead of print]
- A 73-year-old man with chronic respiratory insufficiency was referred to the intensive care unit because of life threatening haemoptysis and hypoxemia. The patient was in respiratory failure with pulmonary arterial hypertension. The bleeding was issuing from the left inferior lobe. A small arterio-v
- PMID 25727656
- Sinus venosus atrial septal defect as a cause of palpitations and dyspnea in an adult: a diagnostic imaging challenge.
- Donovan MS1, Kassop D1, Liotta RA2, Hulten EA1.
- Case reports in medicine.Case Rep Med.2015;2015:128462. doi: 10.1155/2015/128462. Epub 2015 Jan 29.
- Sinus venosus atrial septal defects (SV-ASD) have nonspecific clinical presentations and represent a diagnostic imaging challenge. Transthoracic echocardiography (TTE) remains the initial diagnostic imaging modality. However, detection rates have been as low as 12%. Transesophageal echocardiography
- PMID 25705227
- REPORT OF A RARE ANATOMIC VARIANT: LEFT UPPER LOBE PARTIAL ANOMALOUS PULMONARY VENOUS RETURN.
- De Brucker Y, Ilsen B, Muylaert C, Goethals L, Nieboer K, Fares A, Jager T, de Mey J.
- JBR-BTR : organe de la Société royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR).JBR-BTR.2015 Jan-Feb;98(1):37-8.
- We report the CT findings in a case of partial anomalous pulmonary venous return (PAPVR) from the left upper lobe in an adult. PAPVR is an anatomic variant in which one to three pulmonary veins drain into the right atrium or its tributaries, rather than into the left atrium. This results in a left-t
- PMID 26223064
Japanese Journal
- 肺動脈絞扼術後に感染性肺動脈瘤から主肺動脈右肺動脈瘻を呈した1例
- 黄 義浩,森田 紀代造,松村 洋高,木ノ内 勝史,中村 賢,橋本 和弘
- 日本心臓血管外科学会雑誌 35(5), 292-294, 2006-09-15
- … 症例は9カ月の男児で,DORV, PAPVR, VSD, PH, polysplenia, azygos connectionに対し,生後6カ月時に当院で肺動脈絞扼術を施行した.術後の肺血流のコントロールは良好であったが,術後10日目に多剤耐性表皮ブドウ球菌による敗血症を呈し,2カ月後の胸部CT検査で細菌性心内膜炎による感染性肺動脈瘤および主肺動脈右肺動脈〓を認めた.内科治療中に心不全の急性増悪を呈したため準緊急的に動脈瘤切除,肺動脈再建術および再肺動脈絞扼術 …
- NAID 110004788555
- A-10 PAPVRを合併したと思われる三心房心の一治験例(一般口演 心・大血管)
Related Links
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