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采用诺伍德手术对左旋支食管后主动脉弓型左心发育不全综合征变异型进行主动脉弓移位术。

Translocation of the aortic arch with norwood procedure for hypoplastic left heart syndrome variant with circumflex retroesophageal aortic arch.

作者信息

Lee Chee-Hoon, Seo Dong Ju, Bang Ji Hyun, Goo Hyun Woo, Park Jeong-Jun

机构信息

Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine.

Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine.

出版信息

Korean J Thorac Cardiovasc Surg. 2014 Aug;47(4):389-93. doi: 10.5090/kjtcs.2014.47.4.389. Epub 2014 Aug 5.

DOI:10.5090/kjtcs.2014.47.4.389
PMID:25207249
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4157503/
Abstract

Retroesophageal aortic arch, in which the aortic arch crosses the midline behind the esophagus to the contralateral side, is a rare form of vascular anomaly. The complete form may cause symptoms by compressing the esophagus or the trachea and need a surgical intervention. We report a rare case of a hypoplastic left heart syndrome variant with the left retroesophageal circumflex aortic arch in which the left aortic arch, retroesophageal circumflex aorta, and the right descending aorta with the aberrant right subclavian artery encircle the esophagus completely, thus causing central bronchial compression. Bilateral pulmonary artery banding and subsequent modified Norwood procedure with extensive mobilization and creation of the neo-aorta were performed. As a result of the successful translocation of the aorta, the airway compression was relieved. The patient underwent the second-stage operation and is doing well currently.

摘要

食管后主动脉弓是一种罕见的血管异常形式，其中主动脉弓在食管后方越过中线至对侧。完整形式可能通过压迫食管或气管而引起症状，需要手术干预。我们报告一例罕见的左心发育不全综合征变异型病例，其左主动脉弓呈食管后回旋状，左主动脉弓、食管后回旋主动脉以及伴有迷走右锁骨下动脉的右降主动脉完全环绕食管，从而导致中央支气管受压。进行了双侧肺动脉环扎术，随后进行了改良诺伍德手术，广泛游离并构建了新主动脉。由于主动脉成功移位，气道压迫得以缓解。患者接受了二期手术，目前情况良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19ae/4157503/8a532deeac0b/kjtcvs-47-389f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19ae/4157503/6db15b4aeac7/kjtcvs-47-389f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19ae/4157503/d03c08c7b901/kjtcvs-47-389f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19ae/4157503/8a532deeac0b/kjtcvs-47-389f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19ae/4157503/6db15b4aeac7/kjtcvs-47-389f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19ae/4157503/d03c08c7b901/kjtcvs-47-389f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19ae/4157503/8a532deeac0b/kjtcvs-47-389f3.jpg

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本文引用的文献

1
The Norwood procedure: in favor of the RV-PA conduit.诺伍德手术：支持右心室-肺动脉管道。
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Bilateral pulmonary artery banding for resuscitation in high-risk, single-ventricle neonates and infants: a single-center experience.高危单心室新生儿和婴儿的双侧肺动脉带扎术复苏：单中心经验。
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Multidetector CT scan findings of a right aberrant retroesophageal vertebral artery with an anomalous origin from a cervical aortic arch.
多排 CT 扫描显示右位迷走性食管后椎动脉，其异常起源于颈主动脉弓。
Chest. 2010 Aug;138(2):418-22. doi: 10.1378/chest.09-2244.
4
A rare case of vascular ring: retroesophageal artery between the right brachiocephalic artery and the left descending aorta.一例罕见的血管环病例：右头臂动脉与左降主动脉之间的食管后动脉。
J Thorac Cardiovasc Surg. 2010 Nov;140(5):e76-7. doi: 10.1016/j.jtcvs.2010.06.019. Epub 2010 Jul 16.
5
Comparison of shunt types in the Norwood procedure for single-ventricle lesions.在单心室病变的 Norwood 手术中，不同类型分流术的比较。
N Engl J Med. 2010 May 27;362(21):1980-92. doi: 10.1056/NEJMoa0912461.
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Repair of coarctation in right circumflex retroesophageal arch.右冠状动脉回旋支食管后弓缩窄的修复
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7
Perioperative evaluation of airways in patients with arch obstruction and intracardiac defects.主动脉缩窄和心内缺损患者气道的围手术期评估
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