Nishiori Hironobu, Hagino Ikuo, Koshiyama Hiroshi, Ito Takahiro, Kumae Masaru, Aoki Mitsuru
Department of Cardiovascular Surgery, Chiba Children's Hospital, Chiba City, Chiba, Japan.
J Surg Case Rep. 2023 Feb 14;2023(2):rjad052. doi: 10.1093/jscr/rjad052. eCollection 2023 Feb.
A 9-month-old infant developed pulmonary stenosis (PS) after an arterial switch operation for transposition of the great arteries, accompanied by a Shaher Type 4 coronary anatomy. As the right coronary artery (RCA) ran across the anterior side of the right ventricle (RV), atrioventricular (AV) groove patch plasty was performed to relieve PS. The distance between the RCA and tricuspid valve was confirmed by preoperative-computed tomography. The AV groove was carefully incised, ensuring the position of the tricuspid valve, and maintaining a distance of 3 mm from the tricuspid annulus to avoid approaching the RCA. While suturing the monocuspid valve patch, only the endocardial side of the RV was sutured, and RCA injury was prevented. Thus, especially in patients < 1 year of age, careful incision of the AV groove and suturing only the endocardial side is important to avoid injuring the RCA in AV groove patch plasty.
一名9个月大的婴儿在接受大动脉转位的动脉调转手术后出现了肺动脉狭窄（PS），伴有Shaher 4型冠状动脉解剖结构。由于右冠状动脉（RCA）横跨右心室（RV）前侧，因此进行了房室沟补片成形术以缓解PS。术前计算机断层扫描确定了RCA与三尖瓣之间的距离。小心切开房室沟，确保三尖瓣位置，并保持距三尖瓣环3毫米的距离，以避免靠近RCA。在缝合单尖瓣补片时，仅缝合RV的心内膜侧，防止RCA损伤。因此，尤其是对于年龄小于1岁的患者，小心切开房室沟并仅缝合心内膜侧对于避免在房室沟补片成形术中损伤RCA很重要。
