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心脏导管插入术中医源性损伤后新生儿的血管重建

Vascular Reconstruction in a Neonate after Iatrogenic Injury during Cardiac Catheterization.

作者信息

Amaro Emilie, Pophal Stephen, Zoldos Jozef

机构信息

Vanderbilt School of Medicine, Nashville, Tenn.; Division of Cardiology, Phoenix Children's Hospital Heart Center, Phoenix, Ariz.; College of Medicine, University of Arizona, Arizona Center for Hand Surgery, Phoenix, Ariz.

出版信息

Plast Reconstr Surg Glob Open. 2017 Dec 29;5(12):e1600. doi: 10.1097/GOX.0000000000001600. eCollection 2017 Dec.

Abstract

As technology and interventional techniques continue to evolve, both the volume and complexity of cardiac catheterizations will increase, leading to a rise in the number of complications. One of the most morbid complications of cardiac catheterization is vascular injury. We report the case of a 31-day-old, 3.0-kg infant with hypoplastic left heart syndrome who experienced a left common iliac artery disruption during cardiac catheterization resulting in a retroperitoneal hemorrhage. The extent of the vascular injury combined with the vessel caliber posed a technically challenging surgical scenario. Ultimately, the vascular supply to the left lower extremity was reconstructed by the plastic surgery team with a reverse autologous vein graft. To our knowledge, this multidisciplinary approach with the involvement of plastic surgery represents a unique case.

摘要

随着技术和介入技术不断发展,心脏导管插入术的数量和复杂性都会增加,导致并发症数量上升。心脏导管插入术最严重的并发症之一是血管损伤。我们报告一例31天大、体重3.0千克的左心发育不全综合征婴儿,在心脏导管插入术期间发生左髂总动脉破裂,导致腹膜后出血。血管损伤的程度加上血管管径,构成了具有技术挑战性的手术情况。最终,整形外科团队采用自体静脉逆行移植术重建了左下肢的血管供应。据我们所知,这种有整形外科参与的多学科方法是一个独特的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/658c/5889463/31c22dc89742/gox-5-e1600-g003.jpg

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