Sivalingam Sivakumar, Krishnasamy Sivakumar, Yakub Mohd Azhari
Department of Cardiothoracic Surgery, National Heart Institute, Kuala Lumpur, Malaysia
Department of Cardiothoracic Surgery, National Heart Institute, Kuala Lumpur, Malaysia.
Asian Cardiovasc Thorac Ann. 2015 Jun;23(5):612-4. doi: 10.1177/0218492314540667. Epub 2014 Jun 24.
A 9-year-old boy was referred with a perimembranous ventricular septal defect. At birth, he had undergone a right thoracotomy with ligation of a tracheoesophageal fistula, cervical esophagostomy, and feeding gastrostomy. At 2 years of age, he had gastric tube reconstruction with a pull-through retrosternally, anterior to the heart, and an end-to-end esophagogastric anastomosis. Via a right anterolateral thoracotomy through the previous scar, the entire gastric tube was mobilized away from the sternum to facilitate a median sternotomy. With the patient supine, a median sternotomy was performed without difficulty, and the ventricular septal defect was closed under cardiopulmonary bypass.
一名9岁男孩因膜周部室间隔缺损前来就诊。出生时，他接受了右胸切开术，结扎了气管食管瘘，进行了颈段食管造口术和喂养胃造口术。2岁时，他进行了胃管重建，胃管经胸骨后、心脏前方牵拉上提，并进行了食管胃端端吻合术。经原手术瘢痕行右前外侧开胸，将整个胃管从胸骨游离，以便于进行正中胸骨切开术。患者仰卧位，顺利实施正中胸骨切开术，在体外循环下关闭室间隔缺损。
