Abstract
An anomalous course of the left brachiocephalic vein behind the aortic arch was identified in a patient with tetralogy of Fallot. A 6-year-old male patient had been admitted to the hospital with a diagnosis of tetralogy of Fallot and patent foramen ovale. At the beginning of the operation the left brachiocephalic vein could not be found. The pericardium was opened longitudinally and there was no persistent left superior vena cava. After careful examination, the left brachiocephalic vein was found behind the aorta. Especially during open heart surgery this pathology is very important. We conclude that when the left brachiocephalic vein can not be found, the possibility of persistent left superior vena cava and retro-aortic left brachiocephalic vein should be borne in mind.
Résumé
Un jeune malade de 6 ans a été admis à l'hôpital avec le diagnostic de tétralogie de Fallot avec persistance du foramen ovale. Pendant l'opération, la veine brachio-céphalique gauche n'a pu être mise en évidence initialement. Le péricarde ouvert longitudinalement, on put confirmer l'absence d'une veine cave supérieure gauche. C'est après une exploration minutieuse que la veine brachio-céphalique fut découverte derrière l'aorte. Lorsqu'on constate l'absence de la veine brachio-céphalique gauche, on s'oriente vers une veine cave supérieure gauche persistante. Cette variation est particulièrement importante à connaître, spécialement en chirurgie cardiaque. En conclusion, si l'on ne trouve pas la veine brachio-céphalique gauche en situation habituelle, il faut chercher soit vers une veine cave supérieure gauche persistante, soit vers un tronc brachio-céphalique gauche rétro-aortique.
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Yilmaz, M., Sargon, M.F., Dogan, O.F. et al. A very rare anatomic variation of the left brachiocephalic vein: left retro-aortic brachiocephalic vein with tetralogy of Fallot. Surg Radiol Anat 25, 158–160 (2003). https://doi.org/10.1007/s00276-003-0105-2
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DOI: https://doi.org/10.1007/s00276-003-0105-2