Division of Pediatric Cardiology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin; Herma Heart Institute, Children's Hospital of Wisconsin, Milwaukee, Wisconsin.
Division of Pediatric Cardiology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin; Herma Heart Institute, Children's Hospital of Wisconsin, Milwaukee, Wisconsin.
Ann Thorac Surg. 2019 Jun;107(6):e395-e396. doi: 10.1016/j.athoracsur.2018.09.051. Epub 2018 Nov 8.
Optimal management-balloon dilation versus surgical valvotomy-of neonatal critical aortic stenosis remains controversial. We describe a term neonate with critical aortic stenosis and coarctation, and severe left ventricular dysfunction with endocardial fibroelastosis who underwent palliation with surgical valvotomy and hybrid as a bridge to early biventricular repair. Initial repair consisted of commissurotomy to create bicuspid morphology with placement of bilateral pulmonary artery bands and maintenance of ductal patency with prostaglandin. Left ventricular function improved over the course of 2 weeks, allowing for repeat surgical valvotomy and coarctation repair. The patient was discharged 2 weeks postoperatively with low normal left ventricular function and mild aortic stenosis and regurgitation.
新生儿严重主动脉瓣狭窄的最佳治疗方案——球囊扩张与手术切开——仍存在争议。我们描述了一名患有严重主动脉瓣狭窄合并缩窄、心内膜弹力纤维增生症和严重左心室功能障碍的足月新生儿，他接受了手术切开和杂交治疗作为早期双心室修复的桥接治疗。初始修复包括行房室瓣交界切开术以形成二叶瓣形态，双侧肺动脉带环和前列腺素维持导管通畅。左心室功能在 2 周内逐渐改善，随后再次进行手术切开和缩窄修复。术后 2 周，患儿出院时左心室功能接近正常下限，主动脉瓣狭窄和反流轻度。
