Clinic for Children's Heart Medicine, University Heart & Vascular Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Section of Pediatric Radiology, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Interact Cardiovasc Thorac Surg. 2022 Mar 31;34(4):708-710. doi: 10.1093/icvts/ivab315.
We present a patient with severe tracheal stenosis resulting from a compression by the innominate artery 6 months after an arterial switch operation in a dextro-transposition of the great arteries. Segmentation and three-dimensional (3D) visualization were derived from a contrast-enhanced dual-source computed tomography and post-processing was performed using a dedicated open-source platform (3D Slicer). Post-processing allowed a comprehensible visualization of the relationship of the innominate artery to the trachea when compared to standard computer tomography reformations. Finally, the surgical approach to move the innominate artery anteriorly in order to relieve the tracheal obstruction was emphasized based on the improved 3D visualization of the actual pathology. An effective aortopexy could be performed and the postoperative result was confirmed by a second 3D visualization. About 3 months of follow-up, the patient is completely asymptomatic. Three-dimensional visualization offers excellent opportunities for diagnosis, treatment planning and follow-up in patients with a vascular-related tracheal stenosis in the context of congenital heart disease.
我们介绍了一位患者，他在大动脉转位的动脉调转手术后 6 个月，由于无名动脉压迫导致严重的气管狭窄。通过对比增强双源计算机断层扫描获得了分段和三维（3D）可视化，使用专用的开源平台（3D Slicer）进行了后处理。与标准计算机断层扫描重建相比，后处理允许对无名动脉与气管之间的关系进行易于理解的可视化。最后，根据实际病理的改进 3D 可视化，强调了将无名动脉向前移动以缓解气管阻塞的手术方法。可以进行有效的主动脉固定术，并通过第二次 3D 可视化确认术后结果。约 3 个月的随访后，患者完全无症状。在先天性心脏病的背景下，三维可视化为血管相关气管狭窄患者的诊断、治疗计划和随访提供了极好的机会。
