Mühler E, Engelhardt W, Grabitz R G, Messmer B J, von Bernuth G
Klinik für Kinderkardiologie, RWTH Aachen.
Klin Padiatr. 1991 May-Jun;203(3):137-40. doi: 10.1055/s-2007-1025417.
We report on the history, the diagnostic, and the operative procedure in an infant with congenital stenosis of all pulmonary veins. First symptoms such as failure to thrive, tachydyspnea, tachycardia and hepatomegaly occurred in the eighth week of life. Electrocardiography, 2-dimensional echocardiography and radiography of the chest were unspecific. After recurrent episodes of pulmonary oedema cardiac catheterization was performed: bilaterally elevated pulmonary artery wedge pressure and a normal left atrial pressure proved pulmonary venous obstruction. Severe stenosis of all pulmonary veins was apparent cineangiographically only by selective injections into the right and left pulmonary artery branches in wedge position. The operation (excision of the stenotic area and reimplantation using autologous pericardium) was unsuccessful as in most cases described in the literature. Congenital stenosis of all pulmonary veins is a rapidly progressive malformation. Death occurs usually in the first year of life with and without operation.
我们报告了一名患有所有肺静脉先天性狭窄婴儿的病史、诊断过程及手术操作。最初症状如生长发育迟缓、呼吸急促、心动过速和肝肿大出现在出生后第八周。心电图、二维超声心动图和胸部X光检查均无特异性。在反复出现肺水肿后进行了心导管检查:双侧肺动脉楔压升高而左心房压力正常,证实存在肺静脉梗阻。仅通过楔入位选择性注入左右肺动脉分支进行电影血管造影时,才明显显示出所有肺静脉的严重狭窄。与文献中描述的大多数病例一样,手术(切除狭窄区域并使用自体心包进行再植入)未成功。所有肺静脉的先天性狭窄是一种进展迅速的畸形。无论是否手术,通常在生命的第一年死亡。