We treated two patients with a rare developmental complex. The persistent left superior vena cava draining into the left atrium (PLSVC into LA) was associated with an absent coronary sinus and an atrial septal defect. Ligation of PLSVC and patch-repair of the atrial septal defect were successfully performed in one stage. The atrial septal defect was located in the upper and posterior aspect of the interatrial septum and appeared to be an unique type of atrial septal defect. In the other patient, additional multiple cardiac defects were associated with this syndrome, including ventricular septal defect, pulmonary stenosis, tricuspid insufficiency, and complete transposition of the great arteries. Palliative Blalock procedure was used for this patient. The PLSVC into LA was discovered accidentally in both cases during heart catheterization and it was clearly demonstrated by venography. For a preoperative recognition of PLSVC, computed tomograms of the heart are of great assistance. Surgical correction of the persistent superior vena cava was emphasized for treatment of this syndrome.
In the safety stenting, it is important to get to know the characteristics of a plaque. In petrous carotid artery stenosis, it is difficult to know the characteristics of the plaque. We paid our attention to the MPRAGE (Magnetization Prepared Rapid Acquisition with Gradient Echo) method on high resolving power MRI. By the MPRAGE method, low intensity was observed in these lesions of all cases. This result suggested that the plaque in petrous portion was a fibrous plaque. This method is useful to get to know the characteristics of a plaque in petrous portion before endovascular treatment.
ficulties of diagnostic by an ultrasonography or computed tomography. In some references, the high resolving power MRI was picturized, therefore it was possible to evaluate the plaque characteristics such as soft plaque containing cholesterol, necrosis, haemorrhage, etc. and hard plaque containing fibrous tissue and calcification 8,9. In this study, we evaluated plaque characterization using the MPRAGE method on MRI in ICS on petrous portion. Methods Four patients among treated cases with DSA from November 2003 to August, 2004 are evaluated ICS in petrous portion with MRI-MPRAGE methods. The detail of the high resolving power MRI has been reported as the procedure, and progress of the image pickup procedure.We paid our attention to the MPRAGE method in the various image pickup procedures. This procedure is the method to emphasize the tissue contrast. In ICS of bifurcation, this procedure was also used as control and evaluated effectiveness in plaque characterization. In these four cases, the signal intensity in the MRI-MPRAGE method was estimated as plaque figures and perioperative complication of these patients was investigated.
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