Abd El Rahman M Y, Al Qurashi M M, Al Khalifeh F A
Division of Cardiology, Department of Pediatrics, Al Yamamah Hospital - Riyadh, Saudi Arabia.
J Saudi Heart Assoc. 2011 Jan;23(1):45-7. doi: 10.1016/j.jsha.2010.09.002. Epub 2010 Oct 14.
We present a case of a full-term female neonate who presented at 6 h of age with severe cyanosis and was partially responsive to oxygen supplementation. An echocardiogram showed an isolated congenital severe tricuspid valve insufficiency due to rupture of the papillary muscle of the anterior tricuspid valve leaflet. Magnesium sulfate was infused to lower the pulmonary resistance and thus enhancing the antegrade pulmonary blood flow. Ductal patency was secured by prostaglandin infusion thus providing an additional pulmonary blood flow through the ductus arteriosus. The above measures were adequate to stabilize the patient with no further deterioration or the need for other supportive measures such as Nitric Oxide therapy or extracorporeal membrane oxygenation (ECMO). Therefore, early diagnosis and adequate measures to improve the pulmonary blood flow are mandatory, important pre-operative measures in the management of these patients.
我们报告一例足月女新生儿，出生6小时时出现严重青紫，吸氧后有部分反应。超声心动图显示，由于三尖瓣前叶乳头肌破裂导致孤立性先天性严重三尖瓣关闭不全。输注硫酸镁以降低肺阻力，从而增加肺前向血流量。通过输注前列腺素确保动脉导管通畅，从而通过动脉导管提供额外的肺血流量。上述措施足以使患者病情稳定，未进一步恶化，也无需其他支持措施，如一氧化氮治疗或体外膜肺氧合（ECMO）。因此，早期诊断和采取适当措施改善肺血流量是这些患者治疗中至关重要的术前措施。
