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新生儿主动脉弓梗阻合并动脉导管未闭的关键处理中的双动脉插管

Double Arterial Cannulation in the Critical Management of Neonatal Aortic Arch Obstruction With Closed Ductus Arteriosus.

作者信息

Kulyabin Yuriy Y, Gorbatykh Yuriy N, Soynov Ilya A, Nichay Nataliya R, Zubritskiy Alexey V, Bogachev-Prokophiev Alexander V

机构信息

1 Department of Pediatric Cardiac Surgery, National Medical Research Center, Novosibirsk, Russia.

2 Department of Heart Valve Disease, National Medical Research Center, Novosibirsk, Russia.

出版信息

World J Pediatr Congenit Heart Surg. 2019 Jan;10(1):105-108. doi: 10.1177/2150135118790944.

Abstract

The neonatal management of critical aortic arch obstruction in association with an arterial duct that remains closed or significantly constricted requires urgent surgical repair, with a postoperative focus on resolving the impaired function of compromised organs. Here, we present two neonatal cases illustrating the use of the dual arterial cannulation perfusion method in the complete repair of interrupted aortic arch and critical coarctation of the aorta with nonfunctional ductus arteriosus. We suggest that dual arterial cannulation, which provides total body perfusion (with the exception of cardiac perfusion during cardioplegic arrest of the heart), may be a good alternative to other perfusion strategies in cases of absent ductal blood flow, as this method allowed us to avoid the further development of severe multiple organ failure.

摘要

对于合并动脉导管持续关闭或严重狭窄的危重主动脉弓梗阻新生儿,其管理需要紧急手术修复,术后重点是解决受损器官的功能障碍。在此,我们介绍两例新生儿病例,展示了双动脉插管灌注法在完全修复主动脉弓中断和伴有无功能动脉导管的主动脉严重缩窄中的应用。我们认为,双动脉插管可提供全身灌注(心脏停搏期间心脏灌注除外),在无导管血流的情况下,可能是其他灌注策略的良好替代方法,因为这种方法使我们能够避免严重多器官功能衰竭的进一步发展。

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