Matsui Y, Goh M, Gohda T, Sakai K, Yasuda K, Tanabe T
Second Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Jun;39(6):967-73.
A 33-year-old female with corrected transposition (situs inversus) with ventricular septal defect (VSD), atrial septal defect (ASD), and pulmonary stenosis (valvular and subvalvular) was operated successfully. Closure of ASD and infracristal VSD was performed through right atrial approach. In order to get complete exposure of VSD, a part of anterior leaflet of mitral valve was detached temporally. An external conduit was interposed between the morphologic left ventricle and the main pulmonary artery to relieve pulmonary stenosis. Postoperative course was uneventful except a transient complete heart block for a day. Several technical aspects of the radical operation were discussed including VSD closure method to avoid damaging the atrioventricular conducting tissues and reconstructive procedure of morphological left ventricular outflow.
一名33岁女性,患有矫正性大动脉转位(内脏反位),合并室间隔缺损(VSD)、房间隔缺损(ASD)和肺动脉狭窄(瓣膜及瓣膜下狭窄),手术成功。通过右心房入路关闭ASD和嵴下VSD。为了完全暴露VSD,临时分离了二尖瓣前叶的一部分。在形态学左心室和主肺动脉之间置入一根外管道以缓解肺动脉狭窄。术后过程顺利,仅出现了一天的短暂完全性心脏传导阻滞。讨论了根治性手术的几个技术要点,包括避免损伤房室传导组织的VSD关闭方法以及形态学左心室流出道的重建手术。