无名动脉对气管的压迫。一种简化的无名动脉前悬吊技术。
Innominate artery compression of the trachea. A simplified technique for anterior suspension of the innominate artery.
作者信息
Kamerkar D R, Gladstone D J
机构信息
Department of Cardiac Surgery, Royal Victoria Hospital, Belfast, North Ireland.
出版信息
J Cardiovasc Surg (Torino). 1994 Dec;35(6):549-52.
OBJECTIVE
When innominate artery compression of the trachea causes airway obstruction in infancy, the standard treatment is anterior suspension of the innominate artery by anchoring it to the back of the sternum to relieve the pressure on the trachea, known as aortotruncopexy. We describe a simplified technique for anterior suspension of the innominate artery, by suturing the pretracheal fascia to the back of the manubrium.
EXPERIMENTAL DESIGN
We have used this technique in three infants with follow-up to eighteen months.
SETTING
University teaching hospital, regional paediatric and cardiac surgical centre.
PATIENTS
Three infants presenting with intractable respiratory difficulties, principally caused by the innominate artery compression of the trachea.
INTERVENTION
All patients underwent right thoracotomy. The innominate artery was lifted away from the trachea by creating a pretracheal fascial sling attached to the back of the manubrium.
MEASURES
Clinical follow-up.
RESULTS
All patients have shown improvement in symptoms and none has required further hospitalization.
CONCLUSIONS
This technique appears to give satisfactory results and may reduce the risk of complications, compared with more elaborate operations.
目的
当无名动脉压迫气管导致婴儿气道梗阻时，标准治疗方法是将无名动脉固定于胸骨后进行无名动脉前悬吊术，以减轻对气管的压迫，此即主动脉-气管固定术。我们描述一种简化的无名动脉前悬吊技术，即通过将气管前筋膜缝合至胸骨柄后方来实现。
实验设计
我们已将此技术应用于3例婴儿，并进行了长达18个月的随访。
研究地点
大学教学医院，地区儿科及心脏外科中心。
患者
3例主要因无名动脉压迫气管而出现难治性呼吸困难的婴儿。
干预措施
所有患者均接受右胸切开术。通过创建一个附着于胸骨柄后方的气管前筋膜吊带，将无名动脉从气管上提起。
测量指标
临床随访。
结果
所有患者症状均有改善，且均无需再次住院。
结论
与更为复杂的手术相比，该技术似乎能取得满意效果，并可能降低并发症风险。
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