Mellgren G, Friberg L G
Department of Pediatric Surgery, Ostra sjukhuset, University of Göteborg, Sweden.
Scand J Thorac Cardiovasc Surg. 1994;28(2):49-53. doi: 10.3109/14017439409100162.
Coarctation of the aorta with critical hypoplasia of the aortic arch is a ductus dependent malformation-complex often combined with severe intracardiac malformations with a common denominator: there is a predominance of the pulmonary circulation and a flow restriction through the ascending aorta. Coarctation of the aorta with critical hypoplasia of the aortic arch may be looked upon as a malformation bordering on hypoplastic left heart syndrome. The degree of aortic arch hypoplasia seems to mirror the severity of the intracardiac malformation. The first objective in reconstructing these hearts is to create an unobstructed flow through the aortic arch. Resection of the coarcted segment combined with carotid flap plasty is a surgical alternative which fulfils this objective. We have used the technique in premature-born and severely ill neonates where one-step total correction was considered contraindicated. Thirteen neonates were operated upon, there were no cerebral consequences referable to the carotid artery ligation and no recoarctations.
主动脉缩窄合并主动脉弓严重发育不全是一种依赖动脉导管的复杂畸形，常合并严重的心内畸形，其共同特点是：肺循环占优势，升主动脉存在血流受限。主动脉缩窄合并主动脉弓严重发育不全可被视为一种接近左心发育不全综合征的畸形。主动脉弓发育不全的程度似乎反映了心内畸形的严重程度。重建这些心脏的首要目标是使主动脉弓血流通畅。切除缩窄段并结合颈动脉瓣成形术是实现这一目标的一种手术选择。我们已将该技术应用于被认为禁忌一期完全矫正的早产和重症新生儿。对13例新生儿进行了手术，未出现与颈动脉结扎相关的脑部后果，也没有再发主动脉缩窄。
