Maekawa Y, Sakamoto T, Umezu K, Ohashi N, Harada Y, Yasukochi S, Takigiku K, Takei K, Nakano Y, Inoue N, Otagiri T, Hashida Y
Division of Cardiovascular Surgery, Nagano Children's Hospital, Azumino, Japan.
Kyobu Geka. 2010 Nov;63(12):1028-31.
A male baby was delivered by emergency cesarean section due to fetal distress at 30 weeks of gestational age with a birth weight of 813 g. By fetal echocardiography, the patient had been diagnosed with transposition of great arteries (type 1). Early two-staged arterial switch operation was planned after 34 gestational age avoiding intracranial hemorrhage under cardiopulmonary bypass. At 19 days of life, vegetation was revealed on the pulmonary valve by echocardiography, so he was diagnosed as infectious endocarditis. Cefotaxime and gamma-globulin were given intravenously for 4 weeks. While waiting for the increase in the body weight, desaturation from chronic respiratory distress syndrome was exacerbated. At 8 months old, urgent Senning operation was performed to improve desaturation. The patient was discharged at 20 post operative day. We conclude that Senning operation can be feasible operation in such a complicated case.
一名男婴因胎窘于孕30周时紧急剖宫产出生，出生体重813克。经胎儿超声心动图检查，该患者被诊断为大动脉转位（1型）。计划在孕34周后进行早期两阶段动脉调转手术，在体外循环下避免颅内出血。出生19天时，超声心动图显示肺动脉瓣上有赘生物，因此他被诊断为感染性心内膜炎。静脉给予头孢噻肟和丙种球蛋白治疗4周。在等待体重增加的过程中，慢性呼吸窘迫综合征导致的血氧饱和度下降加剧。8个月大时，进行了紧急森宁手术以改善血氧饱和度下降情况。患者术后第20天出院。我们得出结论，在这种复杂病例中，森宁手术可能是可行的手术。
