Law Mark A, McKenzie E Dean, Slesnick Timothy C, Mott Antonio R
University of Alabama at Birmingham-Pediatric Cardiology, Birmingham, AL 35249-6852, USA.
Congenit Heart Dis. 2009 May-Jun;4(3):174-7. doi: 10.1111/j.1747-0803.2008.00215.x.
Surgical or medical closure of a patent ductus arteriosus (PDA) is a very common practice in premature infants in the neonatal intensive care unit, but often the coronary arteries are not delineated prior to closure. In this report, a 32-week gestational age premature infant who underwent surgical ligation of a PDA developed new-onset left ventricular systolic dysfunction. A repeat echocardiogram noted an anomalous left coronary artery from the pulmonary artery. Successful left coronary artery reimplantation with rapid normalization of left ventricular systolic function occurred. As previously not reported, ligation of a PDA in a premature infant can unmask anomalous left coronary artery from the pulmonary artery. Surgical left coronary artery reimplantation is the mainstay of therapy and should be performed to establish normal coronary blood flow, even in a premature, low birth weight infant.
在新生儿重症监护病房，对早产儿的动脉导管未闭（PDA）进行手术或药物封堵是一种非常常见的操作，但在封堵之前通常不会对冠状动脉进行描绘。在本报告中，一名孕32周的早产儿接受了PDA手术结扎，术后出现了新发的左心室收缩功能障碍。再次超声心动图检查发现左冠状动脉起源于肺动脉异常。成功进行了左冠状动脉再植术，左心室收缩功能迅速恢复正常。如之前未报道的那样，早产儿PDA结扎可能会暴露左冠状动脉起源于肺动脉的异常情况。外科左冠状动脉再植术是主要的治疗方法，即使对于早产、低体重的婴儿，也应进行该手术以建立正常的冠状动脉血流。
