Uno Y, Nakamura Y, Nomura K, Yamashiro M
Department of Cardiovascular Surgery, Tokyo Metropolitan Childrens Hospital, Kiyose, Japan.
Kyobu Geka. 2006 Mar;59(3):206-9.
A 1-year and 11-month-old girl with congenital mitral stenosis (MS) and patent ductus arteriosus (PDA) underwent mitral valve replacement (CarboMedics 16 mm) and ligation of PDA. Though she had suffered from severe postoperative pulmonary hypertension crisis, the inhalation of nitric oxygen (NO) with intravenous use of phosphodiesterase (PDE) III inhibitor and prostaglandin I2 (PGI2) was useful for the postoperative management. Severe pulmonary hypertension is the one of critical postoperative complications for congenital MS with PDA cases. Therefore adequate treatments, such as the combination of NO, PDE Ill inhibitor and PGI2, should be important for those cases. In our case, cardiac catetherization revealed a remaining of pulmonary hypertension under medication of beraprost sodium. Further observation should be necessary for the patient including new medicine, such as sildenafil citrate.
一名1岁11个月大的女孩患有先天性二尖瓣狭窄（MS）和动脉导管未闭（PDA），接受了二尖瓣置换术（CarboMedics 16毫米）和PDA结扎术。尽管她术后出现了严重的肺动脉高压危象，但吸入一氧化氮（NO）并静脉使用磷酸二酯酶（PDE）III抑制剂和前列腺素I2（PGI2）对术后管理很有帮助。严重肺动脉高压是先天性MS合并PDA病例术后的关键并发症之一。因此，对于这些病例，适当的治疗，如联合使用NO、PDE III抑制剂和PGI2，应该很重要。在我们的病例中，心脏导管检查显示在使用贝拉普罗斯钠药物治疗下仍存在肺动脉高压。对该患者需要进一步观察，包括使用新药物，如枸橼酸西地那非。
