Division of Cardiovascular Surgery, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Interact Cardiovasc Thorac Surg. 2020 Oct 1;31(4):578-579. doi: 10.1093/icvts/ivaa139.
Neoaortic root dilation is a common phenomenon after the Norwood procedure, but the real incidence and its natural history are unclear. Regular surveillance in these patients after the operation is necessary. Herein, we present an 11-year-old boy born with tricuspid atresia, a discordant ventriculo-arterial connection and a hypoplastic aortic arch, who was palliated initially with a hybrid stage I procedure involving a reversed Blalock-Taussig shunt, followed by comprehensive stage II and then, an extra-cardiac fenestrated Fontan operation. The patient developed an aortic root aneurysm and severe aortic regurgitation. He was electively taken into the operating room, where cardiopulmonary bypass was established through a peripheral cannulation of the femoral vessels due to the high risk nature of the reoperation. A mechanical Bentall procedure was performed without residual lesions and the native ascending aorta was anastomosed as a single coronary button to the anterior wall of the graft.
升主动脉根部扩张是 Norwood 手术后的常见现象，但真实的发病率及其自然病程尚不清楚。术后对这些患者进行定期监测是必要的。本文报告了 1 例 11 岁男孩，患有三尖瓣闭锁、不一致的心室-动脉连接和主动脉弓发育不良，最初通过涉及逆行 Blalock-Taussig 分流的杂交一期手术进行姑息治疗，随后进行全面的二期手术，然后进行心外腔开窗 Fontan 手术。该患者出现升主动脉瘤和严重主动脉瓣反流。由于再次手术的高风险性质，他被选择性送入手术室，通过股血管的外周插管建立体外循环。进行了机械 Bentall 手术，无残留病变，将升主动脉作为单个冠状动脉瓣吻合到移植物的前壁。
