Surgical Treatment of a Defect Recurring 22 Years after Closure of an Inferior Sinus Venosus Defect: A Case Report.

IF 1.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL Journal of Nippon Medical School Pub Date : 2023-06-29 DOI:10.1272/jnms.JNMS.2023_90-301

Kenji Suzuki, Takashi Sasaki, Keisuke Ohta, Junya Aoyama, Shun-Ichiro Sakamoto, Yoshiyuki Watanabe, Makoto Watanabe, Ryuji Fukazawa, Yosuke Ishii

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Abstract

Background: Residual shunt after closure of an inferior sinus venosus defect (ISVD) is a rare complication with a high rate of reintervention.

Case presentation: Here, we report a rare case of a recurrent defect identified 22 years after closure of an ISVD. The defect (25 × 10 mm) was located at the inferior vena cava-right atrial junction and was closed directly when the patient was 5 years of age. No residual shunt was detected and follow-up was discontinued at age 12 years. However, a residual atrial septal defect shunt was detected incidentally at age 27 years. During the second surgery, the lower end of the original defect was opened and then closed with an expanded polytetrafluoroethylene patch.

Conclusions: Because of the high rate of reintervention for residual shunt after ISVD closure, patch closure was selected as a better option to reduce tension at the inferior-posterior border. Patients with this profile should be followed closely, at least during childhood, including by echocardiography.

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下窦静脉缺损闭合22年后复发的外科治疗一例。

背景:下静脉窦缺损(ISVD)闭合后残留分流是一种罕见的并发症，再介入率很高。病例介绍:在这里，我们报告一个罕见的病例复发缺陷确定22年后ISVD关闭。缺损(25 × 10 mm)位于下腔静脉-右心房交界处，于患者5岁时直接闭合。未发现残留分流，12岁时停止随访。然而，在27岁时偶然发现残留房间隔缺损分流。在第二次手术中，切开原始缺损的下端，然后用膨胀的聚四氟乙烯贴片闭合。结论:由于ISVD闭合后残留分流的再介入率高，选择补片闭合作为减少后下缘张力的较好选择。有这种情况的患者应密切随访，至少在儿童时期，包括超声心动图。

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来源期刊

Journal of Nippon Medical School MEDICINE, GENERAL & INTERNAL-

CiteScore

1.80

自引率

10.00%

发文量

118

期刊介绍： The international effort to understand, treat and control disease involve clinicians and researchers from many medical and biological science disciplines. The Journal of Nippon Medical School (JNMS) is the official journal of the Medical Association of Nippon Medical School and is dedicated to furthering international exchange of medical science experience and opinion. It provides an international forum for researchers in the fields of bascic and clinical medicine to introduce, discuss and exchange thier novel achievements in biomedical science and a platform for the worldwide dissemination and steering of biomedical knowledge for the benefit of human health and welfare. Properly reasoned discussions disciplined by appropriate references to existing bodies of knowledge or aimed at motivating the creation of such knowledge is the aim of the journal.