Pediatric Cardiac Surgery Center, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China.
Interact Cardiovasc Thorac Surg. 2021 Jan 1;32(1):118-121. doi: 10.1093/icvts/ivaa226.
To assess the safety and efficacy of the translocation of the aberrant left subclavian artery (LSCA) and resection of the Kommerell diverticulum during the concomitant repair of intracardiac anomalies for paediatric patients who had a right-sided aortic arch.
A retrospective review of paediatric patients who were diagnosed right-sided aortic arch, aberrant LSCA, Kommerell diverticulum and intracardiac anomalies between 2015 and 2019 was conducted. Patients who underwent translocation of the aberrant LSCA, diverticulum resection and concomitant intracardiac repair were included.
Eight patients underwent translocation of aberrant LSCA, diverticulum resection, ligamentum division and concomitant repair of the associated intracardiac anomalies. All patients were male. The median age was 1.3 years (range 0.4-5.5 years) and the median weight was 10.0 kg (range 6.1-21.0 kg). The most commonly combined intracardiac anomaly was a ventricular septal defect. Seven patients (87.5%) had preoperative respiratory or gastrointestinal symptoms. There was no early mortality and no postoperative complications. During the median follow-up of 23 months (range 4-43 months), no patient had residual respiratory or gastrointestinal symptoms. A postoperative computed tomography scan was performed in 3 patients, all of which showed patent LSCA-left carotid artery anastomosis.
Translocation of the aberrant LSCA and resection of the Kommerell diverticulum can be safely performed during the concomitant repair of intracardiac anomalies for paediatric patients. This approach could eliminate residual respiratory and gastrointestinal symptoms, and prevent reintervention in the future.
评估在同期修复儿童右位主动脉弓合并心内畸形时，对异常左锁骨下动脉（LSCA）移位和 Kommerell 憩室切除的安全性和疗效。
回顾性分析 2015 年至 2019 年期间诊断为右位主动脉弓、异常 LSCA、Kommerell 憩室和心内畸形的儿科患者。纳入接受异常 LSCA 移位、憩室切除、韧带分离和合并心内修复的患者。
8 例患者接受了异常 LSCA 移位、憩室切除、韧带分离和合并心内相关畸形修复。所有患者均为男性，中位年龄为 1.3 岁（范围 0.4-5.5 岁），中位体重为 10.0kg（范围 6.1-21.0kg）。最常见的合并心内畸形是室间隔缺损。7 例（87.5%）患者术前有呼吸或胃肠道症状。无早期死亡，无术后并发症。在中位随访 23 个月（范围 4-43 个月）期间，无患者有残留的呼吸或胃肠道症状。3 例患者术后行计算机断层扫描，均显示 LSCA-左颈动脉吻合通畅。
在同期修复儿童右位主动脉弓合并心内畸形时，可安全地进行异常 LSCA 移位和 Kommerell 憩室切除。这种方法可以消除残留的呼吸和胃肠道症状，预防未来的再次干预。
