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病例报告:三维打印引导下先天性矫正型大动脉转位的外科修复

Case report: Surgical repair of congenitally corrected transposition of the great arteries with the guidance of three-dimensional printing.

作者信息

Zhang Yanchun, Li Yongnan, Ma YuMei, Wei Yalin, He Fengxiao, Zhu Yilin, Lu Weixin, Zhao Yinglu, Wu Xiangyang

机构信息

Department of Cardiovascular Surgery, The Second Affiliated Hospital of Lanzhou University, Lanzhou, China.

出版信息

Front Cardiovasc Med. 2023 Jan 6;9:1101929. doi: 10.3389/fcvm.2022.1101929. eCollection 2022.

Abstract

A 10-year-old girl presented with obvious cyanosis, and the saturation of arterial blood oxygen (SpO) was decreased to 60.5% in the outpatient examination. Computed tomography angiography (CTA) and echocardiography suggested congenitally corrected transposition of the great arteries (ccTGAs), membranous ventricular septal aneurysm (MVSA), atrial septal defect (ASD), severe pulmonary stenosis (PS), and severe tricuspid regurgitation (TR). Due to the complex pathological anatomical structures, the three-dimensional printed model was used for preoperative assessment. After a comprehensive evaluation was completed, the operation was performed by physiological correction under cardiopulmonary bypass, including the resection of MVSA, repair using the bovine pericardial patch for ASD, and linear valvuloplasty of the tricuspid valve. Due to the special anatomical structures of ccTGA, PS was treated by extracardiac pipe technique. After the operation, the patient recovered well, cyanosis disappeared, SpO was up to 96%, and the extracardiac pipe was well-functioning without regurgitation or obstruction.

摘要

一名10岁女孩出现明显紫绀,门诊检查时动脉血氧饱和度(SpO)降至60.5%。计算机断层血管造影(CTA)和超声心动图提示先天性矫正型大动脉转位(ccTGA)、膜周部室间隔瘤(MVSA)、房间隔缺损(ASD)、重度肺动脉狭窄(PS)和重度三尖瓣反流(TR)。由于病理解剖结构复杂,采用三维打印模型进行术前评估。完成全面评估后,在体外循环下进行生理性矫正手术,包括切除MVSA、用牛心包补片修补ASD以及三尖瓣线性瓣膜成形术。由于ccTGA的特殊解剖结构,PS采用心外管道技术治疗。术后患者恢复良好,紫绀消失,SpO高达96%,心外管道功能良好,无反流或梗阻。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c89/9852815/1e52b9206602/fcvm-09-1101929-g001.jpg

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