大动脉d型转位的延迟动脉调转术与糖皮质激素可治性醛固酮增多症

Delayed arterial switch operation for d-transposition of the great arteries and glucocorticoid remediable aldosteronism.

作者信息

Arain Nofil, Braunlin Elizabeth, Louis James St, Bryant Roosevelt

机构信息

Division of Pediatric Cardiology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.

出版信息

World J Pediatr Congenit Heart Surg. 2011 Apr;2(2):316-7. doi: 10.1177/2150135110394217.

DOI:10.1177/2150135110394217

PMID:23804991

Abstract

The Jatene arterial switch operation (ASO) for dextro-transposition of the great arteries is ideally performed within the first 2 weeks of life. Clinical circumstances, however, may dictate a delayed ASO and left ventricle "retraining" prior to the procedure. Glucocorticoid remediable aldosteronism (GRA) accounts for 0.5% to 1% of primary aldosteronism. It presents as severe hypertension in infants and children, with poor response to standard antihypertensive medications. To the authors' knowledge, this is the first reported case of GRA in the context of transposition physiology. The management of GRA and a rationale for delayed ASO are discussed.

摘要

用于大动脉右位转位的贾滕内动脉调转术（ASO）理想情况下应在出生后的头2周内进行。然而，临床情况可能需要延迟进行ASO，并在手术前对左心室进行“再训练”。糖皮质激素可治性醛固酮增多症（GRA）占原发性醛固酮增多症的0.5%至1%。它在婴幼儿中表现为严重高血压，对标准抗高血压药物反应不佳。据作者所知，这是第一例在转位生理学背景下报道的GRA病例。本文讨论了GRA的管理以及延迟进行ASO的理由。