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左肺部分性肺静脉异位连接(It-PAPVC)的外科治疗

Surgical treatment of partial anomalous pulmonary venous connection of the left lung (It-PAPVC).

作者信息

Ban T, Sakata R, Hirata K

机构信息

Department of Cardiovascular Surgery, Kyoto University, Japan.

出版信息

J Card Surg. 1987 Sep;2(3):369-73. doi: 10.1111/j.1540-8191.1987.tb00195.x.

Abstract

Between January 1981 and December 1983, 4 patients, aged 6 to 50 years, with It-PAPVC were operated upon at the Kokura Memorial Hospital, by a new technique of anastomosis between the left anomalous PV and the left auricular appendage. One patient, a 9-year-old male, had unilateral anomalous pulmonary venous connection of the entire left lung to the innominate vein. The other three patients had partial anomalous pulmonary venous connection from the left upper lobe to the innominate vein. Two patients has pulmonary valvular stenosis, and the other two had ASD. All patients were operated upon through a midsternal incision. After cardiopulmonary bypass was established, the anomalous vein was divided as high as was reachable. The present operative method involved the use of an oval pericardial gusset extending from the left auricular appendage into the split anomalous vein so as to obtain a wide anastomotic orifice. Other associated congenital anomalies were simultaneously corrected. All patients had uneventful recovery and at postoperative cardiac catheterization and angiography, the anastomosis between the pulmonary vein and the left auricular appendage was widely patent.

摘要

1981年1月至1983年12月期间,小仓纪念医院对4例年龄在6至50岁之间的部分性肺静脉异位连接(It-PAPVC)患者采用了一种新的手术技术,即左位异常肺静脉与左心耳之间进行吻合。1例9岁男性患者,整个左肺的肺静脉单侧异常连接至无名静脉。另外3例患者为左上肺静脉部分性异常连接至无名静脉。2例患者合并肺动脉瓣狭窄,另外2例合并房间隔缺损(ASD)。所有患者均通过胸骨正中切口进行手术。建立体外循环后,尽可能高位切断异常静脉。目前的手术方法是使用一块椭圆形心包补片,从左心耳延伸至劈开的异常静脉,以获得宽大的吻合口。同时矫正其他合并的先天性畸形。所有患者术后恢复顺利,术后心脏导管检查和血管造影显示,肺静脉与左心耳之间的吻合口通畅。

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