Pridjian A K, Tacy T A, Teske D, Bove E L
Department of Surgery, C. S. Mott Children's Hospital, Ann Arbor, Michigan 48109.
Ann Thorac Surg. 1992 Aug;54(2):355-6. doi: 10.1016/0003-4975(92)91400-4.
Failure to repair transposition of the great arteries and ventricular septal defect in the young infant results in the early development of pulmonary vascular occlusive disease. Complete repair, preferably by an arterial switch procedure and ventricular septal defect closure, may then not be possible. We report a palliative arterial switch procedure in a 5 1/2-year-old patient with transposition, ventricular septal defect, and severe pulmonary vascular obstructive disease in whom progressive hypoxemia and exercise intolerance developed. An arterial repair without ventricular septal defect closure was performed. After the operation, the child's systemic arterial oxygen saturation and exercise tolerance have substantially improved. Although the progression of pulmonary vascular disease may not be altered, arterial repair can provide effective palliation in this subset of patients.
未对婴幼儿的大动脉转位和室间隔缺损进行修复会导致肺血管闭塞性疾病的早期发展。届时可能无法进行完全修复，最好是通过动脉调转手术和室间隔缺损闭合术来修复。我们报告了一例5岁半患有大动脉转位、室间隔缺损和严重肺血管阻塞性疾病的患者，该患者出现了进行性低氧血症和运动不耐受，我们为其实施了姑息性动脉调转手术。手术未闭合室间隔缺损进行了动脉修复。术后，患儿的体循环动脉血氧饱和度和运动耐量有了显著改善。虽然肺血管疾病的进展可能无法改变，但动脉修复可为这部分患者提供有效的姑息治疗。
