Danielson G K, Tabry I F, Ritter D G, Maloney J D
J Thorac Cardiovasc Surg. 1978 Nov;76(5):710-7.
The association of complete atrioventricular canal with other complex congenital cardiac anomalies has represented a significant challenge for the cardiac surgion. The combination of double-outlet right ventricle with complete atrioventricular canal has been particularly difficult to correct, with no surgical successes having been reported until recently. This is a report of the first successful repair of double-outlet right ventricle, complete atrioventricular canal, and atrioventricular discordance (ventricular incersion) associated with common atrium, bilateral superior venae cavae, dextrocardia, and pulmonary stenosis. The specialized conduction tissue was identified by intracardiac electrophysiological mapping, and normal sinus rhythm was preserved. Postoperative cardiac catheterization showed excellent hemodynamics. One year postoperatively, the patient was attending school, playing swimming without difficulty, and taking no cardiac medications. This good result lends encouragement for considering total repair for similar patients with the combination of double-outlet right ventricle, complete atrioventricular canal, and other associated congenital cardiac anomalies.
完全性房室通道与其他复杂先天性心脏畸形的关联一直是心脏外科医生面临的重大挑战。右心室双出口合并完全性房室通道尤其难以矫正,直到最近才有手术成功的报道。本文报告了首例成功修复右心室双出口、完全性房室通道以及合并共同心房、双侧上腔静脉、右位心和肺动脉狭窄的房室不一致(心室反位)的病例。通过心内电生理标测确定了特殊传导组织,并保留了正常窦性心律。术后心脏导管检查显示血流动力学极佳。术后一年,患者上学、游泳均无困难,且无需服用心脏药物。这一良好结果为考虑对患有右心室双出口、完全性房室通道及其他相关先天性心脏畸形组合的类似患者进行全修复提供了鼓励。