Watanabe T, Tajima K, Shimomura T, Ohshima H, Suenaga Y, Iwasa M, Yamori N, Tanaka M, Yasuura K, Murase M
Department of Thoracic Surgery, Nagoya University School of Medicine, Japan.
Kyobu Geka. 1995 Apr;48(4):278-80.
Three neonates with type A interrupted aortic arch were successfully repaired through a median sternotomy incision during profound hypothermia and circulatory arrest in the past one year. Two aortic cannulas, a small plastic one (Cardicorp) in the ascending aorta and a long one inserted through the pulmonary artery and patent ductus arteriosus into the descending aorta. Two Pacifico's venous cannulas were inserted into superior and inferior vena cavae respectively. No dissection and encircling were required around three major branches from the aortic arch and both right and left pulmonary arteries. During a cooling phase a large ventricular septal defect was closed followed by circulatory arrest. It was possible to resect a patent ductus arteriosus and mobilize the descending thoracic aorta for anastomosis to the side of the ascending aorta without removal of the aortic cannula in the aorta. New instruments and development of cardiopulmonary bypass could bring a successful one-stage repair of interrupted aortic arch with ventricular septal defect more safely and easily than before.
在过去一年中,三名患有A型主动脉弓中断的新生儿在深度低温和循环停止期间通过正中胸骨切开术切口成功修复。两根主动脉插管,一根小的塑料插管(Cardicorp)插入升主动脉,另一根长插管通过肺动脉和动脉导管插入降主动脉。两根Pacifico静脉插管分别插入上腔静脉和下腔静脉。无需在主动脉弓的三个主要分支以及左右肺动脉周围进行解剖和环绕。在降温阶段,先关闭大型室间隔缺损,然后进行循环停止。在不移除主动脉内的主动脉插管的情况下,有可能切除动脉导管并游离胸降主动脉,以便与升主动脉侧进行吻合。新的器械和体外循环技术的发展能够比以前更安全、更容易地对伴有室间隔缺损的主动脉弓中断进行成功的一期修复。