Nishi Hiroyuki, Nishigaki Kyoichi, Kume Youichi, Miyamoto Katsuhiko
Department of Pediatric Cardiovascular Surgery, Osaka City General Hospital, 2-13-22 Miyakojima Hondori, Miyakojima-ku, Osaka 534-0021, Japan.
Jpn J Thorac Cardiovasc Surg. 2002 Aug;50(8):338-40. doi: 10.1007/BF03032627.
A 13-month-old boy with recurrent pulmonary venous obstruction (PVO) after repair of total anomalous pulmonary venous connection (TAPVC, Darling IIa + Ia) was treated successfully with in situ pericardium repair consisting of unroofing coronary sinus at 2 months. At 8 months, stenosis of the right upper and lower pulmonary veins (PV) and left lower PV were detected, and PVO was relieved via resection of the stenosis site and recutback. Echocardiography 3 months later showed obstructed bilateral PVs and connection between left PVs and vertical veins. At reoperation, we conducted in situ pericardium repair for right PVO and anastomosed left PVs to the left atrial appendage. The postoperative course was satisfactory. Echocardiography 12 months later showed no evidence of PVO, but cardiac catheterization 12 months later showed mild obstruction on the right side and normal venous drainage on the left. Although the long-term prognosis is unknown, this sutureless technique is effective in recurrent PVO.
一名13个月大的男孩，在完全性肺静脉异位连接（TAPVC，Darling IIa + Ia型）修复术后出现复发性肺静脉梗阻（PVO），在2个月时采用原位心包修复术成功治疗，包括冠状静脉窦开窗。8个月时，检测到右上、下肺静脉（PV）及左下PV狭窄，通过切除狭窄部位并重新修剪缓解了PVO。3个月后的超声心动图显示双侧PV梗阻及左PV与垂直静脉之间的连接。再次手术时，我们对右侧PVO进行原位心包修复，并将左PV与左心耳吻合。术后过程顺利。12个月后的超声心动图显示无PVO迹象，但12个月后的心脏导管检查显示右侧有轻度梗阻，左侧静脉引流正常。尽管长期预后尚不清楚，但这种无缝合技术对复发性PVO有效。
