Oku H, Kamada N, Kitayama H, Yokoyama T, Shirotani H
Department of Cardiovascular Surgery, Kinki University School of Medicine, Osaka, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Nov;40(11):2107-12.
Apico-abdominal-aortic bypass operation was successfully performed for the left ventricular outflow tract obstruction 17 years after correction of Tausig-Bing malformation. At the age of 14 months old, a 18-year-old patient underwent total correction of Taussig-Bing malformation according to Kawashima's intraventricular re-routing. The right ventricular hemodynamics were normal throughout, however, systolic ejection murmur due to aortic stenosis appeared 3 years after repair. Seventeen years postoperatively, marked aortic valve and subaortic obstruction was detected corresponding with the internal conduit made from the duplicated autopericardial baffle. A composite graft containing 23A-SJM valve was interposed between the left ventricular apex and infrarenal abdominal aorta. After the bypass operation, thickness of the posterior wall of the left ventricle and interventricular septum was significantly reduced and symptoms were remarkably improved. The present paper is concerned with the subaortic stenosis after repair of Taussig-Bing malformation and technique of apico-aortic bypass operation.
在矫正陶西格-宾畸形17年后,成功实施了心尖-腹主动脉旁路手术以治疗左心室流出道梗阻。一名18岁患者在14个月大时,根据川岛的脑室内改道方法接受了陶西格-宾畸形的完全矫正。右心室血流动力学一直正常,然而,修复后3年出现了因主动脉狭窄导致的收缩期喷射性杂音。术后17年,检测到明显的主动脉瓣和主动脉下梗阻,与由重复的自体心包挡板制成的内部管道相对应。在左心室心尖和肾下腹主动脉之间置入了一个包含23A-SJM瓣膜的复合移植物。旁路手术后,左心室后壁和室间隔厚度显著减小,症状明显改善。本文关注陶西格-宾畸形修复术后的主动脉下狭窄及心尖-主动脉旁路手术技术。