Jaillard Sophie, Belli Emre, Rakza Thameur, Larrue Benoit, Magnenant Eric, Rey Christian, Storme Laurent
Services de Chirurgie Thoracique, CHRU de Lille, Lille, France.
Ann Thorac Surg. 2005 Jun;79(6):2155-8. doi: 10.1016/j.athoracsur.2003.12.037.
Persistent fetal circulation in transposition of the great arteries results in severe persistent pulmonary hypertension, which increases the risk of early mortality. We report the case of a newborn with transposition of the great arteries and intact ventricular septum associated with pulmonary hypertension. After the failure of immediate balloon atrial septostomy and supportive therapy including inhaled nitric oxide, preoperative extracorporeal membrane oxygenation reversed pulmonary hypertension and ventricular insufficiency and preceded a safe, delayed, cardiac surgical procedure. Unlike the authors of the other few case reports on this subject, we recommend a preoperative stabilization period after discontinuation of extracorporeal membrane oxygenation to avoid left ventricular "deconditioning" and postoperative deterioration related to recurrent persistent pulmonary hypertension.
大动脉转位时的持续性胎儿循环会导致严重的持续性肺动脉高压，从而增加早期死亡风险。我们报告了一例患有大动脉转位且室间隔完整并伴有肺动脉高压的新生儿病例。在即刻球囊房间隔造口术及包括吸入一氧化氮在内的支持治疗失败后，术前体外膜肺氧合逆转了肺动脉高压和心室功能不全，并为安全、延迟的心脏外科手术创造了条件。与关于该主题的其他少数病例报告的作者不同，我们建议在体外膜肺氧合停止后设立一个术前稳定期，以避免左心室“失健”以及与复发性持续性肺动脉高压相关的术后病情恶化。
