Busch U W, Mathur V S, Garcia E, Cooley D A, de Castro C M, Hall R J
Arch Intern Med. 1978 Sep;138(9):1423-4.
A patient with tetralogy of Fallot who underwent a successful Blalock shunt procedure as a child was evaluated 28 years later because of clinical deterioration. Results of cardiac catheterization and angiography disclosed, in addition to a functioning shunt, evidence of an infundibular, subvalvular tumor and a large anastomosis between the left circumflex coronary artery and the bronchial arteries of the right lung with the possibility of "coronary steal". At operation, the Blalock and coronary-to-bronchial artery anastomoses were ligated; and total correction was performed including resection of the pulmonary valve and infundibulum, excision of the tumor, closure of the ventricular septal defect, and application of an outflow patch to enlarge the pulmonary annulus. The patient was discharged nine days after surgical correction.
一名患有法洛四联症的患者在儿童时期接受了成功的布莱洛克分流手术，28年后因临床病情恶化接受评估。心导管检查和血管造影结果显示，除了分流功能正常外，还存在漏斗部、瓣膜下肿瘤，以及左旋冠状动脉与右肺支气管动脉之间的大吻合，有可能出现“冠状动脉窃血”。手术中，结扎了布莱洛克分流和冠状动脉至支气管动脉的吻合；进行了全面矫正，包括切除肺动脉瓣和漏斗部、切除肿瘤、闭合室间隔缺损以及应用流出道补片扩大肺动脉环。患者在手术矫正后九天出院。
