Ohuchi H, Yagihara T, Kishimoto H, Isobe F, Yamamoto F, Kawashima Y
Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Dec;39(12):2229-33.
A 5-year-old boy with double inlet left ventricle and ventriculoarterial discordance (SDD type) underwent ventricular septation with arterial switch procedure. Previously he had received pulmonary arterial banding at 3 months-old. Preoperative cardiac catheterization revealed Qp/Qs 1.26, Pp/Ps 0.19 and LVEDV was 315% of normal (as left ventricle). Arterial switch with Lecompte modification was performed in order to separate ventricle with straight patch could be done. Post operative course was uneventful and patient was extubated 4 post operative day. These procedures had employed in this patient as follows; 1) systemic ventricle could be constructed with morphological left ventricle with mitral valve. 2) left ventricular outflow tract stenosis due to ventricular outlet foramen occasionally observed in conventional procedure such as intraventricular rerouting could be prevented, and 3) ventricular septation could be easy and simple with straight patch.
一名患有双入口左心室和心室动脉不一致(SDD型)的5岁男孩接受了室间隔修补术和动脉调转术。他此前在3个月大时接受了肺动脉环扎术。术前心脏导管检查显示Qp/Qs为1.26,Pp/Ps为0.19,左心室舒张末期容积(LVEDV)是正常左心室的315%。为了能用直补片分离心室,实施了带有勒孔特改良术式的动脉调转术。术后过程顺利,患者在术后第4天拔除气管插管。该患者采用了以下这些手术步骤:1)形态学上的左心室与二尖瓣可构建出体循环心室;2)在诸如心室内改道等传统手术中偶尔会观察到的由于心室出口孔导致的左心室流出道狭窄可得到预防;3)使用直补片可使室间隔修补术变得简单易行。