Watanabe T, Abe T, Tanaka M, Takeuchi E, Yasuura K, Hikosaka H, Suenaga Y, Hosokawa H, Iwasa M, Yamori N
Department of Thoracic Surgery, Nagoya University School of Medicine.
Kyobu Geka. 1992 Aug;45(9):827-30.
Leftward shift of the infundibular septum (IS) in interrupted aortic arch (IAA) with ventricular septal defect (VSD) often develops significant left ventricular outflow obstruction (LVOTO). Seven-day-old boy with 2.6 kg body weight underwent the two-stage operation for this anomaly. The aortic arch was interrupted between the left common carotid and the left subclavian artery. At the first stage, a 5 mm GORE-TEX graft was used to connect the interrupted arch, and pulmonary artery banding was performed. In closure of VSD at the second stage, IS was penetrated by stitches for the VSD patch to left ventricular outflow tract. IS with leftward shift could be pulled toward right ventricular side with patch fixation and LVOTO was prevented by this method.
患有室间隔缺损(VSD)的主动脉弓中断(IAA)患者,其漏斗间隔(IS)向左移位常导致严重的左心室流出道梗阻(LVOTO)。一名体重2.6千克的7日龄男婴因该畸形接受了两阶段手术。主动脉弓在左颈总动脉和左锁骨下动脉之间中断。在第一阶段,使用5毫米的戈尔特斯(GORE-TEX)移植物连接中断的主动脉弓,并进行了肺动脉环扎术。在第二阶段关闭室间隔缺损时,通过缝线将室间隔缺损补片穿过漏斗间隔至左心室流出道。通过补片固定,可将向左移位的漏斗间隔拉向右心室侧,以此方法预防左心室流出道梗阻。