Sachdeva Ashwin, Bansal Ramesh C, Bailey Leonard L, Razzouk Anees J
Department of Cardiovascular & Thoracic Surgery, Loma Linda University Medical Center & Children's Hospital, Loma Linda, CA 92354, USA.
Tex Heart Inst J. 2011;38(4):412-4.
Balloon atrial septostomy is ordinarily a safe palliative procedure for cyanotic congenital heart disease; however, if echocardiographic guidance is unavailable and fluoroscopy is used, distortions in the cardiac anatomy can invalidate the usual landmarks. Herein, we report iatrogenic mitral papillary muscle rupture during balloon atrial septostomy in a 4-day-old male neonate with total anomalous connection of the pulmonary veins. The anomalous connection and severe mitral regurgitation were emergently corrected, and the patient grew and developed normally. At age 24 years, he had only mild residual mitral regurgitation and was in New York Heart Association functional class I.In addition to describing the surgical treatment and positive late outcome of a rare complication, we highlight the importance of accurately evaluating balloon catheter location during atrial septostomy, especially in patients with a small left atrium.
球囊房间隔造口术通常是治疗青紫型先天性心脏病的一种安全的姑息性手术；然而，如果无法进行超声心动图引导而使用荧光透视法，心脏解剖结构的变形可能会使常用的解剖标志无效。在此，我们报告了一名4日龄患有完全性肺静脉异位连接的男性新生儿在球囊房间隔造口术期间发生医源性二尖瓣乳头肌破裂的病例。该患儿的异位连接和严重二尖瓣反流得到了紧急纠正，且患儿生长发育正常。在24岁时，他仅存在轻度二尖瓣反流残余，纽约心脏协会心功能分级为I级。除了描述一种罕见并发症的外科治疗及良好的远期预后外，我们还强调了在房间隔造口术期间准确评估球囊导管位置的重要性，尤其是对于左心房较小的患者。
