Left superior vena cava cannulation and drainage through coronary sinus

Permanent perfusion of the left superior vena cava into the coronary sinus is most common in vena cava malformations, accounting for 2% to 4% of congenital heart disease. Up to 40% can be associated with visceral transposition. There are usually the following three cases: 1 left and right superior vena cava coexist, while left unnamed vein has sufficient caliber; 2 left and right superior vena cava coexist, left unnamed vein hypoplasia; 3 right superior vena cava lack. The introduction of the left superior vena cava into the coronary sinus does not cause hemodynamic abnormalities, and there are no obvious clinical symptoms, but sometimes it can cause coronary sinus rhythm or other heart rhythm disorders. Curing disease: Indication Transcatheter drainage through the superior left superior vena cava of the coronary sinus is applicable to: 1. The left and right superior vena cava coexist, but the left innominate vein is dysplastic, or there is not enough traffic between the left and right superior vena cava. 2. The right superior vena cava is absent. Surgical procedure 1. The chest midline incision. 2. Longitudinal cuts of happy packets, extra-sonal exploration to determine the vena cava. The heart was gently pulled to the right to expose the left superior vena cava, and the lower edge of the left superior vena cava was bluntly separated by a vascular clamp, and the obstruction band was placed. 3. Closed coronary sinus intubation is suitable for cases of absence of right superior vena cava. The surgeon inserted the index finger into the right atrial appendage, and made a small incision in the right atrial wall. A small incision was made, and the vena cava catheter was inserted. The vena cava catheter was delivered to the left superior vena cava through the coronary sinus ostium to the distal end of the obstruction band under the guidance of the index finger. . 4. Intubation of the coronary sinus under direct vision When the right superior vena cava is present, the superior and inferior vena cava and the left superior cavity can be blocked when the cardiopulmonary perfusion is initiated after the intubation of the superior and inferior vena cava and the ascending aorta. Intravenous, open the right atrium, and quickly deliver the left superior vena cava catheter through the coronary sinus ostium into the left superior vena cava under direct vision. At this time, the obstruction band should be temporarily released, so that the tip of the catheter enters the left superior vena cava. End to achieve drainage purposes.