Hasegawa Tomomi, Yamaguchi Masahiro, Yoshimura Naoki, Oka Shigeteru, Nishijima Eiji, Tsugawa Chikara
Department of Cardiothoracic Surgery, Kobe Children's Hospital, Kobe, Japan.
Jpn J Thorac Cardiovasc Surg. 2003 Dec;51(12):688-91. doi: 10.1007/s11748-003-0013-8.
Vascular rings due to aortic arch anomalies can be a major cause of tracheoesophageal obstruction in infants. But there is no report of vascular ring in an extremely low birth weight (ELBW) infant. This is a report of an infant with birth weight of 560 g, who has not diagnosed vascular ring until 6 months of age because of asymptomatic process by prolonged tracheal intubation. The patient was treated for double aortic arch with tracheomalacia surgically by simple division of the atretic left arch and the ligamentum arteriosus, aortopexy and tracheostomy before reaching full recovery at 3 years of age. We reported our management of vascular rings in the ELBW infant. This case suggested that the difficulty of extubation in ELBW infants in spite of the improvement of respiratory condition should raise a suspicion of the tracheal compression by other lesions such as vascular rings.
主动脉弓异常导致的血管环可能是婴儿气管食管梗阻的主要原因。但极低出生体重（ELBW）婴儿血管环尚无报道。本文报告1例出生体重560g的婴儿，因长期气管插管无症状过程，直到6个月大才诊断出血管环。该患者接受了双主动脉弓合并气管软化症的手术治疗，通过简单分离闭锁的左弓和动脉韧带、主动脉固定术和气管造口术，在3岁时完全康复。我们报告了对ELBW婴儿血管环的处理。该病例提示，尽管呼吸状况有所改善，但ELBW婴儿拔管困难应怀疑存在血管环等其他病变导致的气管受压。
