Kutsuzawa Rieko, Tominaga Yuji, Shibagaki Keisuke, Takashima Satoru, Sakaguchi Heima, Iwai Shigemitsu
Department of Pediatric Cardiac Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan.
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
Ann Thorac Surg Short Rep. 2024 Apr 18;2(3):414-417. doi: 10.1016/j.atssr.2024.03.011. eCollection 2024 Sep.
Undetected coronary anomalies at Norwood procedure are associated with poor prognosis due to inadequate myocardial protection. We report a case of anomalous origin of the right coronary artery from the main pulmonary artery trunk with hypoplastic left heart syndrome and aortic atresia. Although, during bilateral pulmonary artery banding as initial palliation, the proximity between the right coronary artery origin and the aortic root made a visual diagnosis difficult, it was diagnosed using computed tomography before the Norwood procedure. The Norwood procedure is safe in patients with coronary anomalies after accurate diagnosis to ensure intraoperative myocardial protection.
在诺伍德手术中未被发现的冠状动脉异常与心肌保护不足导致的预后不良有关。我们报告一例右冠状动脉起源于主肺动脉干合并左心发育不全综合征和主动脉闭锁的病例。尽管在作为初始姑息治疗的双侧肺动脉环扎术期间，右冠状动脉起源与主动脉根部之间的接近度使视觉诊断困难，但在诺伍德手术前通过计算机断层扫描得以诊断。在准确诊断后，诺伍德手术对于有冠状动脉异常的患者是安全的，以确保术中的心肌保护。
