Fujimatsu T, Tsunemoto M, Shimada M, Ohta Y, Endoh S, Watari T, Ishizawa A, Koike K, Nihei K
Department of Cardiovascular Surgery, National Children's Hospital, Tokyo, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Jul;38(7):1093-8.
Surgical repair of the mixed type total anomalous pulmonary venous connection (TAPVC) in infancy is known to be difficult. In this report, experience of two infants with the mixed type TAPVC with the left upper pulmonary vein (PV) draining into the innominate vein and the other PVs into the coronary sinus (IIa + Ia (left upper PV) type TAPVC) is presented. In such cases, it has been said that the left upper PV should be left uncorrected, but we anastomosed the left upper PV, that was thin and fragile, to the left atrium and corrected all the other anomalous PVs. The results were satisfactory. Recently, Extra-Corporeal circulation, microsurgery, and other techniques have significantly progressed, so we consider that the anastomosis is possible in most infants with IIa + Ia (left upper PV) type TAPVC. In the future, careful clinical follow-up and repeat catheterizations should be done, and we'd like to examine the long term patency of the left upper PV.
婴儿期混合型完全性肺静脉异位连接(TAPVC)的手术修复已知具有挑战性。在本报告中,介绍了两例混合型TAPVC婴儿的经验,其中一例左上肺静脉(PV)汇入无名静脉,其他肺静脉汇入冠状窦(IIa + Ia(左上PV)型TAPVC)。在这种情况下,有人说左上肺静脉不应纠正,但我们将纤细脆弱的左上肺静脉与左心房吻合,并纠正了所有其他异常肺静脉。结果令人满意。近来,体外循环、显微外科手术和其他技术有了显著进展,因此我们认为大多数IIa + Ia(左上PV)型TAPVC婴儿都有可能进行吻合。未来应进行仔细的临床随访和重复导管检查,我们希望检查左上肺静脉的长期通畅情况。