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术中支气管镜检查在可能伴有气道阻塞的先天性心脏畸形手术修复中的应用:三例报告

Usefulness of intraoperative bronchoscopy during surgical repair of a congenital cardiac anomaly with possible airway obstruction: three cases report.

作者信息

Oh JongEun, Kim Jung-Won, Shin Won-Jung, Gwak Mijeung, Park Pyung Hwan

机构信息

Department of Anesthesiology and Pain Medicine, Asan Medical Center, Seoul, Korea.

出版信息

Korean J Anesthesiol. 2016 Feb;69(1):71-5. doi: 10.4097/kjae.2016.69.1.71. Epub 2016 Jan 28.

Abstract

Compression of the airway is relatively common in pediatric patients, although it is often an unrecognized complication of congenital cardiac and aortic arch anomalies. Aortopexy has been established as a surgical treatment for tracheobronchial obstruction associated with vascular anomaly, aortic arch anomaly, esophageal atresia, and tracheoesophageal fistula. The tissue-to-tissue arch repair technique could result in severe airway complication such as compression of the left main bronchus which was not a problem before the correction. We report three cases of corrective open heart surgery monitored by intraoperative bronchoscopy performed during prebypass, and performed immediately before weaning from bypass, to evaluate tracheobronchial obstruction caused by congenital, complex cardiac anomalies in the operating room.

摘要

气道受压在儿科患者中相对常见,尽管它常常是先天性心脏和主动脉弓畸形未被识别的并发症。主动脉固定术已被确立为治疗与血管异常、主动脉弓畸形、食管闭锁和气管食管瘘相关的气管支气管梗阻的外科手术方法。组织对组织的弓修复技术可能导致严重的气道并发症,如左主支气管受压,而在矫正前这并不是问题。我们报告三例在体外循环前、即将停止体外循环时进行术中支气管镜监测的矫正性心脏直视手术病例,以评估手术室中由先天性复杂心脏畸形引起的气管支气管梗阻情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b379/4754271/f33ec23797c5/kjae-69-71-g001.jpg

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