Ishibashi Nobuyuki, Aoki Mitsuru, Fujiwara Tadashi
Department of Cardiovascular Surgery, Chiba Children's Hospital, Chiba, Japan.
Cardiol Young. 2005 Aug;15(4):431-3. doi: 10.1017/S1047951105000909.
We performed an arterial switch operation in a patient with double outlet right ventricle with non-committed ventricular septal defect, and abnormal insertion of the tension apparatus of the tricuspid valve which produced moderate tricuspid regurgitation. This required extensive enlargement of the ventricular septal defect between the attachments of the cords of the tricuspid valve so as to create the interventricular rerouting that made possible the arterial switch operation. Postoperatively, we produced a straight, unobstructed, left ventricular outflow tract, improved the extent of tricuspid regurgitation, and achieved low right atrial pressures. Enlargement of the interventricular communication can set the scene for biventricular repair in this particular subset of patients with both arterial trunks arising from the morphologically right ventricle.
我们对一名患有右心室双出口且室间隔缺损不定位、三尖瓣腱索附着异常并导致中度三尖瓣反流的患者进行了动脉调转手术。这需要在三尖瓣腱索附着处之间广泛扩大室间隔缺损，以建立心室间改道，从而使动脉调转手术成为可能。术后，我们构建了一条笔直、无梗阻的左心室流出道，减轻了三尖瓣反流程度，并使右心房压力降低。对于这一特定亚组的患者，即两个动脉干均发自形态学右心室的情况，扩大心室间交通可为双心室修复创造条件。
