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[主动脉弓中断及需要在体外循环下修复的心脏畸形病变。附3例报告]

[Interruption of the aortic arch and malformative cardiac lesions requiring repair under extracorporeal circulation. Apropos of 3 cases].

作者信息

Bical O, Tran Viet T, Laborde F, Khalife K, Villain E, De Geeter B, Lecompte Y, Roy A, Leca F, Neveux J Y

出版信息

Arch Mal Coeur Vaiss. 1985 May;78(5):729-33.

PMID:3925915
Abstract

Interruption of the aortic arch is practically always associated with intracardiac malformations of variable complexity, at the least, a ventricular septal defect. Surgery is usually performed in two stages: aortic repair and pulmonary artery banding after intravenous prostaglandin administration. The second stage comprises debanding and repair of the intracardiac lesions under cardiopulmonary bypass. However, in some cases, interruption of the aortic arch is associated with intracardiac lesions which necessitate correction under cardiopulmonary bypass from the onset, this was the situation in two of the three cases described by the authors: aorto-pulmonary window, a lesion which can only be corrected under circulatory arrest and deep hypothermia. One of these two children, operated in the neonatal period, did not survive: the other, operated at 6 weeks, had an excellent result. In the third case, the association of tricuspid atresia and a restrictive ventricular septal defect necessitated enlargement of the septal defect and therefore, open heart surgery under circulatory arrest; the results were favourable.

摘要

主动脉弓中断几乎总是与复杂程度各异的心脏内畸形相关,至少伴有室间隔缺损。手术通常分两个阶段进行:静脉注射前列腺素后进行主动脉修复和肺动脉束带术。第二阶段包括在体外循环下解除束带并修复心脏内病变。然而,在某些情况下,主动脉弓中断与心脏内病变相关,这些病变从一开始就需要在体外循环下进行矫正,作者描述的三个病例中有两个就是这种情况:主肺动脉窗,这种病变只能在循环停止和深度低温下矫正。这两个患儿中的一个在新生儿期接受手术,未能存活;另一个在6周时接受手术,效果极佳。在第三个病例中,三尖瓣闭锁合并限制性室间隔缺损需要扩大室间隔缺损,因此需要在循环停止下进行心脏直视手术;结果良好。

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