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青少年法乐四联症患者行后路脊柱侧凸矫形术时发生主肺动脉间隔狭窄的围手术期管理。

Perioperative Management of an Adolescent Fontan Patient with Narrowing of the Aortopulmonary Space for Posterior Scoliosis Surgery.

机构信息

Division of Anesthesiology, Intensive Care and Emergency Medicine, 89098University Medical Center Utrecht, Utrecht, The Netherlands.

Department of Pediatric Cardiology, Wilhelmina Children's Hospital, 89098University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

Semin Cardiothorac Vasc Anesth. 2022 Sep;26(3):221-225. doi: 10.1177/10892532221114285. Epub 2022 Aug 11.

DOI:10.1177/10892532221114285
PMID:35953886
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9460710/
Abstract

Congenital cardiac patients who received neonatal reconstructive aortic arch surgery are at risk of aortopulmonary space narrowing with compression of the left pulmonary artery and left main bronchus (LMB) later in life. We discuss a challenging adolescent single ventricle patient who presented for surgical treatment of a non-idiopathic thoracic scoliosis (posterior spinal fusion) with severe stenosis of the LMB and left pulmonary artery due to a narrow aortopulmonary space. Careful preoperative imaging, evaluation, and decision making resulted in successful surgical treatment and uneventful perioperative course.

摘要

患有先天性心脏病的新生儿接受主动脉弓重建手术后，其主动脉-肺动脉间隔可能会变窄，导致左肺动脉和左主支气管（LMB）受压，进而在以后的生活中出现狭窄。我们讨论了一位具有挑战性的青少年单心室患者，该患者因主动脉-肺动脉间隔狭窄而出现非特发性胸脊柱侧凸（后路脊柱融合术），伴有 LMB 和左肺动脉严重狭窄，前来接受手术治疗。术前仔细的影像学检查、评估和决策使手术治疗取得成功，围手术期也没有出现并发症。

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Perioperative Management of an Adolescent Fontan Patient with Narrowing of the Aortopulmonary Space for Posterior Scoliosis Surgery.青少年法乐四联症患者行后路脊柱侧凸矫形术时发生主肺动脉间隔狭窄的围手术期管理。
Semin Cardiothorac Vasc Anesth. 2022 Sep;26(3):221-225. doi: 10.1177/10892532221114285. Epub 2022 Aug 11.
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本文引用的文献

1
Surgical Correction of Scoliosis in Children with Severe Congenital Heart Disease and Palliated Single Ventricle Physiology.儿童严重先天性心脏病和单心室姑息治疗后脊柱侧凸的手术矫正。
Spine (Phila Pa 1976). 2021 Jul 15;46(14):E791-E796. doi: 10.1097/BRS.0000000000003905.
2
The role of bioresorbable intraluminal airway stents in pediatric tracheobronchial obstruction: A systematic review.生物可吸收腔内气道支架在小儿气管支气管阻塞中的作用：系统评价。
Int J Pediatr Otorhinolaryngol. 2020 Dec;139:110405. doi: 10.1016/j.ijporl.2020.110405. Epub 2020 Sep 30.
3
Perioperative Considerations for the Fontan Patient Requiring Noncardiac Surgery.
《非心脏手术的 Fontan 患者的围手术期注意事项》。
Anesthesiol Clin. 2020 Sep;38(3):531-543. doi: 10.1016/j.anclin.2020.04.001. Epub 2020 Jul 16.
4
Augmentation of pulmonary blood flow and cardiac output by non-invasive external ventilation late after Fontan palliation.非侵入性体外通气在 Fontan 姑息术后晚期对肺血流量和心输出量的增强作用。
Heart. 2021 Jan;107(2):142-149. doi: 10.1136/heartjnl-2020-316613. Epub 2020 Jul 6.
5
Adverse Perioperative Events in Children with Complex Congenital Heart Disease Undergoing Operative Scoliosis Repair in the Contemporary Era.当代复杂先天性心脏病患儿接受脊柱侧弯手术修复时的围手术期不良事件
Pediatr Cardiol. 2019 Oct;40(7):1468-1475. doi: 10.1007/s00246-019-02169-1. Epub 2019 Jul 26.
6
Novel aortic arch reconstruction using a modified Norwood procedure based on hypoplastic left heart syndrome-specific anatomical malformations.基于左心发育不全综合征特异性解剖畸形，采用改良诺伍德手术进行新型主动脉弓重建。
Interact Cardiovasc Thorac Surg. 2018 Aug 1;27(2):243-249. doi: 10.1093/icvts/ivy047.
7
Fontan Fenestration Closure Prior to Posterior Spinal Fusion in Patients With Single-Ventricle Heart Disease.单心室心脏病患者后路脊柱融合术前的Fontan开窗闭合术
Spine (Phila Pa 1976). 2016 Dec 1;41(23):E1425-E1428. doi: 10.1097/BRS.0000000000001630.
8
Scoliosis surgery in children with congenital heart disease.儿童先天性心脏病脊柱侧凸手术。
Spine (Phila Pa 1976). 2014 Feb 1;39(3):E211-8. doi: 10.1097/BRS.0000000000000083.
9
Mechanical ventilation strategy following Glenn and Fontan surgeries: On going challenge!格林手术和Fontan手术后的机械通气策略：持续的挑战！
J Saudi Heart Assoc. 2009 Jul;21(3):153-7. doi: 10.1016/j.jsha.2009.06.005. Epub 2009 Aug 15.
10
A review of mechanical ventilation strategies in children following the Fontan procedure.法洛四联症修复术后儿童机械通气策略综述。
Images Paediatr Cardiol. 2002 Apr;4(2):4-11.