Opie J C, Taylor G, Ashmore P G, Kalousek D
J Thorac Cardiovasc Surg. 1981 Mar;81(3):459-63.
A neonate presented at this institution in September, 1978, with interrupted aortic arch complex, including ventricular septal defect, atrial septal defect, and patent ductus arteriosus. Additional anomalies included bilateral cleft lip and palate, low set ears, and bilateral colobomas. One-stage total correction of the interrupted aortic arch complex was undertaken with standard hypothermic techniques. The repair was completed within a 65 minute period of circulatory arrest at 18 degrees C, perfusion was re-established, and the patient was returned to normothermia. Tetanic contracture of the myocardium, stone heart, was evident at 27 degrees C. Cardiac action did not resume despite several therapeutic maneuvers, and the infant died on the operating table. Extensive calcium flooding was a notable feature on histological sections of the heart, associated with myofibrillar degeneration (contraction bands). This complication has never been reported before in a neonate with congenital heart disease. Deep hypothermia did not prevent ischemic contracture of the myocardium, and this complication must now be added to an already lengthy list of complications of neonatal heart surgery.
1978年9月，一名新生儿因主动脉弓中断综合征就诊于本院，该综合征包括室间隔缺损、房间隔缺损和动脉导管未闭。其他异常包括双侧唇腭裂、低位耳和双侧脉络膜缺损。采用标准低温技术对主动脉弓中断综合征进行一期完全矫正。修复在18摄氏度下循环停止65分钟内完成，恢复灌注，患者恢复正常体温。在27摄氏度时可见心肌强直性收缩，即石心。尽管采取了多种治疗措施，心脏活动仍未恢复，婴儿死于手术台上。心脏组织学切片上一个显著特征是大量钙浸润，并伴有肌原纤维变性（收缩带）。这种并发症在先天性心脏病新生儿中此前从未有过报道。深度低温并不能预防心肌缺血性挛缩，现在这种并发症必须被添加到已经很长的新生儿心脏手术并发症列表中。
