Sasaki T, Shiina Y, Abe K, Kimura H, Hamada Y, Niitu K
Third Department of Surgery, School of Medicine, Iwate Medical University, Morioka, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Mar;38(3):488-92.
A surgically corrected case of tetralogy of Fallot with anomalous origin of left pulmonary artery from the ascending aorta is presented. The patient was under-developed 3-year-old girl. She weighed only 1,000 grams at birth and had a systolic heart murmur and slight cyanosis. Echocardiography demonstrated the features of tetralogy of Fallot shortly after birth. Chest roentgenogram showed right ventricular enlargement, but vascular marking of lung was almost normal. Catheterization and cineangiography demonstrated the findings of tetralogy of Fallot. Final diagnosis of anomalous origin of left pulmonary artery from ascending aorta was confirmed by aortography. Surgical correction was accomplished using cardiopulmonary bypass with surface cooling. The left pulmonary artery was detached from the aorta and anastomosed to the main pulmonary artery. Pulmonary valve stenosis and severe infundibular hypertrophy were corrected, and ventricular septal defect was closed with a patch. Postoperative recovery was uneventful. On follow up after surgery, she appears to be in very good condition.
本文介绍了一例法洛四联症外科矫治病例，该病例中左肺动脉起自升主动脉。患者为一名发育不良的3岁女童。她出生时体重仅1000克，有收缩期心脏杂音和轻度发绀。出生后不久，超声心动图显示了法洛四联症的特征。胸部X线片显示右心室增大，但肺部血管纹理基本正常。心导管检查和心血管造影显示了法洛四联症的表现。主动脉造影证实了左肺动脉起自升主动脉的最终诊断。采用体表降温的体外循环进行外科矫治。将左肺动脉从主动脉上分离下来，并与主肺动脉吻合。矫正了肺动脉瓣狭窄和严重的漏斗部肥厚，用补片封闭室间隔缺损。术后恢复顺利。术后随访时，她的状况看起来非常良好。
