Horvath P, Dinwiddie R, Stark J
Thoracic Unit, Hospital for Sick Children, London, UK.
Eur J Cardiothorac Surg. 1990;4(7):351-3; discussion 354. doi: 10.1016/1010-7940(90)90041-w.
Two patients (aged 10 and 16 months) underwent right pneumonectomy: one for an oesophageal bronchus, the other for a hypoplastic right lung with sequestration. Both patients subsequently developed severe stridor. The heart rotated to the right and the aortic arch compressed the trachea. This unusual vascular compression was treated by a bypass graft between the ascending and descending aorta and division of the aortic arch between the left carotid and left subclavian artery at the age of 5 years and 4 months, and 20 months respectively. The postoperative recovery was uneventful in the first patient. The second patient required 7 weeks of ventilatory support. Both patients are well (14 and 7 years after surgery). Cardiac catheterisation and angiography in the first patient and Doppler echocardiography in the second demonstrated unrestricted flow through the graft into the descending aorta. Pulmonary function studies showed a restrictive defect with some obstruction in both children. Despite this finding, both patients enjoy a normal life with some sporting activities. The long-term results suggest the effectiveness of this procedure in the treatment of this rare but severe complication of pneumonectomy in infancy.
两名患者（年龄分别为10个月和16个月）接受了右肺切除术：一名因食管支气管，另一名因右肺发育不全伴肺隔离症。两名患者随后均出现严重喘鸣。心脏向右旋转，主动脉弓压迫气管。这种不寻常的血管压迫分别在5岁4个月和20个月时通过升主动脉和降主动脉之间的旁路移植以及左颈动脉和左锁骨下动脉之间的主动脉弓离断进行治疗。第一名患者术后恢复顺利。第二名患者需要7周的通气支持。两名患者目前情况良好（术后分别为14年和7年）。第一名患者进行了心导管检查和血管造影，第二名患者进行了多普勒超声心动图检查，结果均显示移植血管内血流无阻地流入降主动脉。肺功能研究显示两名儿童均存在限制性缺陷并伴有一定程度的阻塞。尽管有此发现，但两名患者都能进行一些体育活动，过着正常生活。长期结果表明该手术在治疗婴儿期这种罕见但严重的肺切除术后并发症方面是有效的。
