Pigott J D, Chin A J, Weinberg P M, Wagner H R, Norwood W I
J Thorac Cardiovasc Surg. 1987 Jul;94(1):82-6.
Transposition of the great arteries (S,D,D) is a common congenital cardiovascular malformation that is occasionally associated with ventricular septal defect and left ventricular outflow tract obstruction. Recently right ventricular outflow tract obstruction associated with an aortic arch anomaly has been recognized as an infrequent but important variant of transposition of the great arteries, and this constellation presents a unique surgical challenge. Five infants with this constellation whose systemic circulation was dependent on flow through the ductus arteriosus have undergone definitive surgical treatment with four survivors. An anatomical review of 129 specimens with transposition of the great arteries revealed that 17% had right ventricular outflow tract obstruction and 7% had associated aortic arch obstruction as well. All specimens with aortic arch obstruction and ventricular septal defect except one had a malalignment type ventricular septal defect. Although several treatment options may be considered, recent experience with arterial switch repair in the neonate with transposition of the great arteries (S,D,D) prompted repair in these patients by arterial switch, ventricular septal defect closure, repair of aortic arch obstruction, and augmentation of the right ventricular outflow tract.
大动脉转位（S，D，D型）是一种常见的先天性心血管畸形，偶尔伴有室间隔缺损和左心室流出道梗阻。最近，与主动脉弓异常相关的右心室流出道梗阻被认为是大动脉转位的一种罕见但重要的变异类型，这种情况带来了独特的手术挑战。五例患有这种情况且体循环依赖动脉导管血流的婴儿接受了确定性手术治疗，四例存活。对129例大动脉转位标本的解剖学研究显示，17%存在右心室流出道梗阻，7%同时伴有主动脉弓梗阻。除一例标本外，所有伴有主动脉弓梗阻和室间隔缺损的标本均为对位不良型室间隔缺损。尽管可以考虑多种治疗方案，但最近在大动脉转位（S，D，D型）新生儿中进行动脉调转术的经验促使对这些患者采用动脉调转术、室间隔缺损修补术、主动脉弓梗阻修复术以及右心室流出道扩大术进行治疗。
