Yoshitake Shuichi, Kaneko Yukihiro, Yakuwa Kazuki, Achiwa Ikuya
1 Division of Cardiovascular Surgery, National Center for Child Health and Development, Setagaya, Tokyo, Japan.
World J Pediatr Congenit Heart Surg. 2019 May;10(3):384-387. doi: 10.1177/2150135117690110. Epub 2017 Jun 14.
Surgical management of truncus arteriosus, or common arterial trunk, has expanded over the past three decades to include earlier surgical intervention, initially during infancy and now chiefly in the neonatal period. Many studies have shown that preoperative truncal valve insufficiency is an independent risk factor for mortality. We herein present the case of a five-month-old boy with severe truncal valve insufficiency who underwent repair of common arterial trunk and prosthetic replacement of the truncal valve with associated annular enlargement after initial stabilization in the newborn period via palliative bilateral pulmonary artery banding. We believe that initial bilateral pulmonary artery banding represents a viable option for some cases of common arterial trunk involving truncal valve insufficiency.
动脉干畸形(又称共同动脉干)的外科治疗在过去三十年中不断发展,涵盖了更早的手术干预,最初是在婴儿期,现在主要是在新生儿期。许多研究表明,术前动脉干瓣膜关闭不全是死亡的独立危险因素。我们在此报告一例五个月大患有严重动脉干瓣膜关闭不全的男孩病例,该患儿在新生儿期通过姑息性双侧肺动脉环扎术初步稳定病情后,接受了共同动脉干修复及动脉干瓣膜人工置换并伴有瓣环扩大手术。我们认为,对于一些涉及动脉干瓣膜关闭不全的共同动脉干病例,最初的双侧肺动脉环扎术是一种可行的选择。