针对肺动脉右锁骨下动脉异常的 C 型主动脉弓中断的安井手术:无右锁骨下动脉移植技术。

Fabian A Kari, Sebastian Michel, André Jakob, Jürgen Hörer
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引用次数: 0

摘要

一名男性新生儿(2.5 千克)患有 C 型主动脉弓中断、主动脉瓣发育不良和左心室流出道梗阻,作为混合临时姑息治疗的第一步,他接受了双侧肺动脉带治疗。由于左侧颈总动脉起源处有内膜组织瓣,且存在 PDA 支架植入的高风险,因此进行了早期完全矫正。为了进行完全矫正,利用右锁骨下动脉作为游离移植物,将其植入左右颈总动脉之间,重建了主动脉弓的大弯度。左侧颈总动脉被缩短,血管起源处的内膜组织瓣被切除。建立达穆斯-凯-斯坦塞勒吻合术,并通过右心室切口关闭室间隔缺损。用 Contegra 牛颈静脉导管建立了右心室到肺动脉的连续性。
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Yasui procedure for an interrupted aortic arch type C with an aberrant right subclavian artery from the pulmonary artery: right subclavian artery-free graft technique.

A male neonate (2.5 kg) who presented with an interrupted aortic arch type C, hypoplasia of the aortic valve and left ventricular outflow tract obstruction received bilateral pulmonary artery bands as a first step of a hybrid interim palliation. Due to an intimal tissue flap at the origin of the left common carotid artery and a high-risk situation for PDA stenting, a complete early correction was undertaken. For full correction, the large curvature of the aortic arch was reconstructed using the aberrant right subclavian artery as a free graft by implanting it between the right and left common carotid arteries. The left common carotid artery was shortened, and an intimal tissue flap at the origin of the vessel was removed. A Damus-Kaye-Stansel anastomosis was created, and the ventricular septal defect was closed through a right ventricular incision. Right ventricular-to-pulmonary artery continuity was established with a Contegra bovine jugular vein conduit.

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来源期刊
CiteScore
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发文量
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期刊介绍: The Multimedia Manual of Cardio-Thoracic Surgery (MMCTS) is produced by The European Association for Cardio-Thoracic Surgery (EACTS). MMCTS is the world’s premier video-based educational resource for cardiovascular and thoracic surgeons; freely accessible - and essential - for all. MMCTS was launched more than ten years ago under the leadership of founding editor Professor Marko Turina. It was Professor Turina’s vision that the European Association for Cardio-Thoracic Surgery (EACTS), already the world-leader in CT surgery education, should take advantage of the Internet’s rapidly improving video publication capabilities and create a new step-by-step manual of surgical procedures. Professor Turina and EACTS agreed that the manual, MMCTS, should be freely accessible to all users, regardless of association membership status, nationality, or affiliation. MMCTS was self-published by EACTS for some years before being transferred to Oxford University Press, which hosted it until the end of 2016. In November 2016, the Manual returned home to EACTS and it has now relaunched in a completely new format. Since its birth in 2005, MMCTS has published some 400 detailed, video-based demonstrations of cardio-thoracic surgical procedures. Tutorials published prior to 2012 have been archived and we are working with the authors of these tutorials to update their work pending republication on the new site. Our mission is to make MMCTS the best online reference for cardio-thoracic surgeons – residents and experienced surgeons alike. Our aim is to include tutorials presenting procedures at both a fundamental and an advanced level. Truly innovative procedures are also included and are identified as such.
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