Department of Cardiovascular Surgery, Kobe Children's Hospital, Kobe, Japan.
Department of Cardiovascular Surgery, Kobe Children's Hospital, Kobe, Japan.
Ann Thorac Surg. 2020 Sep;110(3):e181-e183. doi: 10.1016/j.athoracsur.2020.01.037. Epub 2020 Feb 28.
Simultaneous repair of congenital tracheal and cardiovascular lesions remains challenging in small patients. We describe two infants weighing less than 3 kg who underwent successful tracheoplasty with concomitant correction of complex heart anomalies. In both operations, cardiopulmonary bypass was switched to extracorporeal membrane oxygenation after cardiac repair to optimize hemostatic function with transfusion and maintain activated clotting time at 200 to 240 seconds. Slide tracheoplasty was performed in a bloodless field, which prevented intraoperative hemorrhage from running down the divided lower trachea into the lung and causing airway obstruction. Both patients were weaned from extracorporeal support during surgery and extubated within 9 days.
在小患者中，同时修复先天性气管和心血管病变仍然具有挑战性。我们描述了两名体重不足 3 公斤的婴儿，他们成功地进行了气管成形术，并同时纠正了复杂的心脏异常。在这两个手术中，在心脏修复后，心肺转流切换到体外膜氧合，以通过输血优化止血功能，并将激活凝血时间维持在 200 到 240 秒。在无血的情况下进行滑动气管成形术，可防止术中出血从切开的下段气管流入肺部并导致气道阻塞。两名患者均在手术中成功撤离体外支持，并在 9 天内拔管。
