Maekawa Yoshiyuki, Sakamoto Takahiko, Umezu Kentaro, Ohashi Nobuo, Harada Yorikazu, Yasukochi Satoshi, Takigiku Kiyohiro, Takei Kota, Nakano Yusuke, Inoue Nao, Otagiri Tesshu, Hashida Yuichiro
Division of Cardiovascular Surgery, Nagano Children's Hospital, Azumino, Japan.
Kyobu Geka. 2011 Mar;64(3):249-53.
Operative correction of tetralogy of Fallot has been performed for more than 50 years and well established. To date, the literature on reoperation has focused and indications and the long-term outcome have not been well defined. We herein report a case of pulmonary valve replacement due to ectopic ossification on expanded polytetrafluoroethylene (ePTFE) cusp in a female child who had undergone right ventricular outflow tract reconstruction for tetralogy of Fallot with pulmonary atresia. Because of severe right ventricular dilatation with end diastolic volume of 186 ml/m2 on cardiac catheterization, redo operation was planned for functional recovery of the right ventricle. Previous transannlar patch was removed and pulmonary valve replacement was performed using CEP 23 mm. A hard calcification was observed around the cusp of transannular patch. Pathological findings revealed ectopic ossification with osteoblast colonization around the ePTFE cusp. This is the 1st report of ectopic ossification on ePTFE.
法洛四联症的手术矫正已经开展了50多年，技术成熟。迄今为止，关于再次手术的文献主要集中在手术指征方面，而长期疗效尚未明确界定。我们在此报告一例女童，因法洛四联症合并肺动脉闭锁接受右心室流出道重建术后，其膨体聚四氟乙烯（ePTFE）瓣叶出现异位骨化而进行肺动脉瓣置换。由于心脏导管检查显示严重的右心室扩张，舒张末期容积为186 ml/m²，计划再次手术以恢复右心室功能。移除先前的跨环补片，使用23 mm的CEP进行肺动脉瓣置换。在跨环补片瓣叶周围观察到硬钙化。病理结果显示ePTFE瓣叶周围有成骨细胞定植的异位骨化。这是关于ePTFE异位骨化的首例报告。
