Hasan Ghaith, Almjersah Abdulrahman, Younes Mohamed
Department of Surgery, Faculty of Medicine, Damascus University, Damascus, Syria.
Syrian Medical Research Group, Damascus, Syria.
J Surg Case Rep. 2024 Oct 3;2024(10):rjae621. doi: 10.1093/jscr/rjae621. eCollection 2024 Oct.
We present the case of a 7-month-old female infant with a history of recurrent respiratory infections and symptoms of respiratory distress during feeding. Echocardiography isolated revealed supracardiac-type total anomalous pulmonary venous connection with a large ostium secundum atrial septal defect and severe pulmonary hypertension. Computed tomographic angiography confirmed the diagnosis and identified stenosis at the level of the venous confluence. The surgical intervention involved a novel approach using dual anastomoses between the pulmonary venous confluence and the left atrium, alongside atrial septal defect repair with a bovine pericardial patch. Postoperative recovery was uneventful, with successful weaning from mechanical ventilation on Day 9 and discharge on Day 12. The patient showed optimal venous drainage and hemodynamic stability, indicating a successful surgical outcome. This case highlights the importance of early surgical intervention in total anomalous pulmonary venous connection with complex anatomical presentations.
我们报告一例7个月大的女婴,有反复呼吸道感染病史,且在喂养期间出现呼吸窘迫症状。经超声心动图单独检查发现为心上型完全性肺静脉异位连接,伴有大型继发孔房间隔缺损和严重肺动脉高压。计算机断层血管造影证实了诊断,并确定了静脉汇合处的狭窄。手术干预采用了一种新方法,即肺静脉汇合处与左心房之间进行双吻合,同时用牛心包补片修补房间隔缺损。术后恢复顺利,第9天成功脱离机械通气,第12天出院。患者显示出最佳的静脉引流和血流动力学稳定性,表明手术结果成功。该病例突出了在具有复杂解剖表现的完全性肺静脉异位连接中早期手术干预的重要性。