Mesher Andrew L, Hermsen Joshua L, Rubio Agustin E, Chen Jonathan M, McMullan David Michael
Department of Surgery, University of Washington School of Medicine, Seattle, Washington.
Division of Cardiac Surgery, Seattle Children's Hospital, Seattle, Washington.
Ann Thorac Surg. 2015 Feb;99(2):709-10. doi: 10.1016/j.athoracsur.2014.03.051.
Hypoplastic left heart syndrome is the most common diagnosis among infants requiring cardiac extracorporeal life support (ECLS) in the neonatal period, with more than half of patients experiencing an ECLS-related complication. We present a case of nearly obstructing neoaortic thrombus during ECLS occurring in the early postoperative period after modified Norwood palliation of hypoplastic left heart syndrome. Stasis within the neoaortic root due to the increased ventricular afterload associated with venoarterial ECLS may have potentiated this complication. Echocardiographic monitoring and early cardiac catheterization while on ECLS enabled prompt diagnosis and timely surgical correction.
左心发育不全综合征是新生儿期需要心脏体外生命支持（ECLS）的婴儿中最常见的诊断，超过半数的患者会出现与ECLS相关的并发症。我们报告一例左心发育不全综合征改良诺伍德姑息术后早期ECLS期间发生的新主动脉血栓形成，几乎导致梗阻。与静脉-动脉ECLS相关的心室后负荷增加导致新主动脉根部血流淤滞，可能促使了这一并发症的发生。ECLS期间的超声心动图监测和早期心导管检查实现了及时诊断和手术矫正。
