Loureiro Petra, Georgiev Stanimir, Ewert Peter, Tanase Daniel, Eicken Andreas, Kammer Birgit, Dalla-Pozza Robert
Department of Pediatric Cardiology and Congenital Heart Disease, Hospital de Santa Marta, Nova University Lisbon, Lisbon, Portugal.
Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technische Universität München, Munich, Germany.
Cardiovasc Diagn Ther. 2021 Apr;11(2):631-636. doi: 10.21037/cdt-20-380.
Cyanosis persisting after surgical repair of complex congenital heart disease (CHD) may be related to the underlying disease. However, extracardiac causes should be also considered. We report on a patient with heterotaxy syndrome and double outlet right ventricle, in whom postoperative cyanosis was associated with an Abernethy malformation type II causing a hepatopulmonary syndrome. Despite this complex anatomy, interventional closure of the portosystemic shunt was done with a Konar MF™-VSD Occluder. The patient recovered rapidly with relief of cyanosis within one month. This case highlights the importance of a careful diagnostic assessment in patients with complex CHD, who presents cyanoses after surgical repair. In addition, it shows the feasibility and safety of a percutaneous approach with complete closure of the vascular malformation in a patient with a complex anatomy.
复杂先天性心脏病(CHD)手术修复后持续存在的紫绀可能与潜在疾病有关。然而,心外原因也应予以考虑。我们报告一例患有内脏异位综合征和右心室双出口的患者,其术后紫绀与导致肝肺综合征的II型阿伯内西畸形有关。尽管解剖结构复杂,但使用Konar MF™-室间隔缺损封堵器对肝门静脉分流进行了介入封堵。患者迅速康复,紫绀在1个月内得到缓解。该病例强调了对复杂CHD手术后出现紫绀的患者进行仔细诊断评估的重要性。此外,它还显示了在解剖结构复杂的患者中采用经皮方法完全闭合血管畸形的可行性和安全性。