Najm Hani, Gupta Sohini, Weingarten Noah, Stewart Robert, Ahmad Munir, Lane John, Amdani Shahnawaz, Karamlou Tara
22508Cleveland Clinic Children's Hospital, Vascular, and Thoracic Institute, Cleveland.
2546Case Western Reserve University School of Medicine, Cleveland.
World J Pediatr Congenit Heart Surg. 2022 May;13(3):389-392. doi: 10.1177/21501351211054380. Epub 2021 Nov 13.
Optimal management of critical aortic stenosis (AS) in infants depends on the left ventricle's (LV's) ability to maintain adequate output. Determining feasibility of biventricular repair may be difficult, particularly in those with mitral disease, endocardial fibroelastosis (EFE), multi-level obstruction, and uncertain physiologic capacity. We report a case of a three-month-old with critical AS, severely reduced LV function, EFE, and moderate mitral regurgitation (MR), who underwent a Ross-Konno procedure with concomitant EFE resection and mitral valve repair. Although the technical sequence is challenging, definitive surgery completely relieved multi-level obstruction and MR with markedly improved LV function.
婴儿严重主动脉瓣狭窄(AS)的最佳管理取决于左心室(LV)维持足够输出量的能力。确定双心室修复的可行性可能很困难,尤其是对于患有二尖瓣疾病、心内膜弹力纤维增生症(EFE)、多级梗阻以及生理功能不确定的患者。我们报告了一例三个月大的严重AS患儿,其左心室功能严重降低,患有EFE和中度二尖瓣反流(MR),该患儿接受了Ross-Konno手术,并同时进行了EFE切除术和二尖瓣修复术。尽管手术技术操作具有挑战性,但确定性手术完全解除了多级梗阻和MR,左心室功能明显改善。