[完全性室间隔完全性主动脉缩窄新生儿大动脉转位一期修复1例]。

K Kurisu, K Yonenaga, N Furusho, K Nishimura, K Yatsunami
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引用次数: 0

摘要

我们报告一个新生儿病例一期修复大动脉转位与完整的室间隔(TGA与IVS)和主动脉缩窄(CoA)。手术是在27天大时进行的,当时患者为男性,体重为3408克。术前心导管及血管造影证实TGA合并IVS、CoA、房间隔缺损、动脉导管未闭、持续性左上腔静脉、左侧附件近置、右心。手术是通过左开胸同时进行锁骨下瓣主动脉成形术和通过正中胸骨切开进行动脉转换手术。病人的术后过程很顺利,他长得很好。术后心导管检查显示轻度肺动脉狭窄(右心室与肺动脉之间的压力梯度为19 mmHg),动脉切换操作导致轻度主动脉弓扭结。锁骨下瓣主动脉成形术联合动脉转换术一期修复,对这一复杂畸形提供了良好的临床效果。
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[A case report of one-stage repair for transposition of the great arteries with intact ventricular septum and coarctation of the aorta in neonate].

We report a neonatal case of one-stage repair for transposition of the great arteries with intact ventricular septum (TGA with IVS) and coarctation of the aorta (CoA). The surgery was performed at 27 days of age when the patient, a male, weighed 3408 g. Preoperative cardiac catheterization and angiography confirmed the diagnosis of TGA with IVS, CoA, atrial septal defect, patent ductus arteriosus, persistent left superior vena cava, left sided juxta-positioning of appendages and dextrocardia. The procedure was simultaneous subclavian flap aortoplasty through a left thoracotomy and an arterial switch operation through a median sternotomy. The patient's postoperative course was uneventful and he has grown well. Postoperative cardiac catheterization revealed mild pulmonary stenosis (pressure gradient of 19 mmHg between the right ventricle and the pulmonary artery) and mild aortic arch kinking from the arterial switch maneuver. One-stage repair, the combination of subclavian flap aortoplasty and arterial switch operation, provides a good clinical result in this complex malformation.

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