Feil E, Arnold G, Borowski A, Mennicken U
Abteilung Kinderkardiologie, Universität zu Köln.
Z Kardiol. 1992 May;81(5):283-9.
Two different clinical manifestations of perigraft-reactions complicating the implantation of prosthetic aortopulmonary shunts in children with cyanotic congenital heart disease are described and discussed. The incidence of this complication in the past 5 years in our own patients was 3%. The appearance of a localized mass on the chest film surrounding the prosthesis requires the exclusion of a hematoma, aneurysm or inflammation. In the case of a massive serous pleural effusion examination of the ingredients leads to diagnosis. Concerning our own patients the fluid is identical with serum; the leakage through the prosthesis can therefore be called plasmapheresis. The claimed pathogenetic causes are discussed intensively, including a chylothorax promoting this complication in the second case. Local variations in porosity and structure of the implanted prosthesis may play a critical role in the pathogenesis of perigraft-reaction, as indicated by both our reported cases. In the event of unsuccessful observation of a localized perigraft seroma or of unsuccessful chest drainage of a massive pleural serous effusion, graft replacement and placement of a different graft material are found to have the best results.
描述并讨论了在患有青紫型先天性心脏病的儿童中，人工体肺动脉分流植入术后并发的两种不同临床表现的移植物周围反应。在过去5年中，我们自己的患者中这种并发症的发生率为3%。胸部X光片上假体周围出现局部肿块需要排除血肿、动脉瘤或炎症。对于大量浆液性胸腔积液，对其成分进行检查可得出诊断。就我们自己的患者而言，积液与血清相同；因此，通过假体的渗漏可称为血浆置换。深入讨论了所声称的发病原因，包括在第二种情况下促进这种并发症的乳糜胸。如我们报告的两个病例所示，植入假体的孔隙率和结构的局部差异可能在移植物周围反应的发病机制中起关键作用。如果对局部移植物血清肿的观察不成功，或者对大量胸腔浆液性积液的胸腔引流不成功，发现更换移植物并放置不同的移植物材料效果最佳。
