Yamaguchi M, Oshima Y, Hosokawa Y, Ohashi H, Tsugawa C, Nishijima E, Tsubota N
Department of Thoracic-Cardiovascular Surgery, Kobe Children's Hospital, Japan.
J Thorac Cardiovasc Surg. 1990 Aug;100(2):181-7.
Severe obstructive lesion of the trachea combined with complex congenital cardiac anomaly has generally been regarded as a fatal disease. Herein we report the successful concomitant repair of severe tracheal stenosis and complex cardiac anomaly with the use of cardiopulmonary bypass in two cases. The first patient was a 5-year-old boy with tetralogy of Fallot associated with a localized intrathoracic tracheal stenosis caused by complete cartilaginous rings. Tracheal resection and end-to-end anastomosis combined with total correction of tetralogy of Fallot was performed with the aid of cardiopulmonary bypass. The second patient was a 5-month-old girl with a pulmonary artery sling, scimitar syndrome, and extensive tracheal stenosis. The patient underwent definitive correction of cardiac lesions and complete tracheal reconstruction with a cartilaginous graft with the aid of cardiopulmonary bypass. Utmost care was paid to avoid contamination during the operation. Both of the patients are doing well at present without any signs of complication, 2 years 5 months and 1 year 10 months after the operation, respectively. We advocate concomitant repair of both lesions, with cardiopulmonary bypass, in the surgical managements of infants and small children who have a difficult and otherwise fatal combination of complex congenital cardiac anomaly and severe intrathoracic tracheal stenosis.
气管严重阻塞性病变合并复杂先天性心脏畸形通常被视为一种致命疾病。在此，我们报告两例通过体外循环成功同时修复严重气管狭窄和复杂心脏畸形的病例。首例患者为一名5岁男孩，患有法洛四联症，伴有由完整软骨环引起的局限性胸段气管狭窄。在体外循环辅助下进行了气管切除端端吻合术并同时对法洛四联症进行了根治。第二例患者是一名5个月大的女孩，患有肺动脉吊带、弯刀综合征和广泛气管狭窄。该患者在体外循环辅助下接受了心脏病变的根治性矫正以及使用软骨移植物进行的完全气管重建。术中极其小心以避免污染。目前两名患者术后分别为2年5个月和1年10个月，情况良好，无任何并发症迹象。我们主张在患有复杂先天性心脏畸形和严重胸段气管狭窄这一困难且通常致命组合的婴幼儿手术治疗中，通过体外循环同时修复这两种病变。
