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一名罕见的患有浆果综合征的成年患者成功进行了一期手术修复。

Successful one-stage surgical repair in a rare adult patient with berry syndrome.

作者信息

Pan Sisi, Bai Jue, Wang Feng, Yang Siyuan, Hu Xuanyi, Peng Wanfu, Liang Guiyou

机构信息

Department of Cardiovascular Surgery, The Affiliated Hospital of Guizhou Medical University, Guizhou, China.

出版信息

Perfusion. 2024 May 4:2676591241251438. doi: 10.1177/02676591241251438.

Abstract

BACKGROUND

Berry syndrome is a rare congenital cardiac malformation, herein we report an adult male patient who was successfully repaired by one-stage surgery.

CASE DESCRIPTION

18-year-old male patient presenting symptoms of chest tightness and shortness for over a year presented to outpatient clinic in our department to have corrective procedure heart. CTA revealed an Aortopulmonary Window (APW) type III, measuring 4.6 cm in maximum diameter. The right pulmonary artery originated from the ascending aorta, and the pulmonary trunk exhibited dilation with dimensions of 8.3 cm × 5.7 cm × 5.9 cm. Additional findings included Interrupted Aortic Arch (IAA) type A, intact ventricular septum, and Patent Ductus Arteriosus (PDA). Echocardiography showed bidirectional shunt at the level of APW in severe pulmonary hypertension. The right heart catheterization indicated a mean pulmonary artery pressure of 70mmHg and a pulmonary artery resistance of 5 Wood units. We evaluated after two weeks of treatment with epoprostenol at a rate of 20 ng/(kg. min) and found a significant improvement in pulmonary-artery pressure. Finally, we communicated with the patient's family and decided to proceed with the procedure.

CONCLUSIONS

For complex cardiovascular malformations, the ideal treatment strategy must be tailored to the characteristics of the patient to provide maximum efficacy and safety.

摘要

背景

贝里综合征是一种罕见的先天性心脏畸形,在此我们报告一名成年男性患者通过一期手术成功修复。

病例描述

一名18岁男性患者,出现胸闷和气短症状一年多,前来我院门诊进行心脏矫正手术。CT血管造影显示为III型主肺动脉窗,最大直径为4.6厘米。右肺动脉起源于升主动脉,肺动脉干扩张,尺寸为8.3厘米×5.7厘米×5.9厘米。其他发现包括A型主动脉弓中断、室间隔完整和动脉导管未闭。超声心动图显示主肺动脉窗水平双向分流,伴有严重肺动脉高压。右心导管检查显示平均肺动脉压为70mmHg,肺动脉阻力为5伍德单位。我们以20纳克/(千克·分钟)的速率用依前列醇治疗两周后进行评估,发现肺动脉压有显著改善。最后,我们与患者家属沟通并决定进行手术。

结论

对于复杂的心血管畸形,理想的治疗策略必须根据患者的特点进行定制,以提供最大的疗效和安全性。

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