Gontijo B, Fantini F, Barbosa M, Gomes M V, Gutierrez C, Vrandecic M
Biocor Institute, Biocor Hospital de Doenças Cardiovasculares Ltda., Belo Horizonte, MG, Brazil.
Eur J Cardiothorac Surg. 1994;8(7):391-2. doi: 10.1016/1010-7940(94)90035-3.
The association of transposition of the great arteries (TGA) and total anomalous pulmonary venous return (TAPVR) is very rare; we report one case of this malformation with an intracardiac type of TAPVR draining into the coronary sinus. The surgical repair was performed directing the coronary sinus blood flow to the tricuspid valve. The proximity of the anatomical structures allowed an intra-atrial patch repair similar to a modified Mustard procedure. In the postoperative period the child developed low cardiac output for 2 days, requiring inotropic support and mechanical ventilation. Her recovery was otherwise uneventful. The postoperative echocardiogram showed an intact repair with perfect flow through the patch from the pulmonary veins to the right ventricle. Almost 2 years after surgery, the patient underwent cardiac catheterization that showed integrity of the surgical repair with normal pressures in all heart chambers. To our knowledge this is the first report in the medical literature of surgical treatment of this association.
大动脉转位(TGA)与完全性肺静脉异位引流(TAPVR)合并存在的情况极为罕见;我们报告了一例这种畸形病例,其心内型TAPVR引流至冠状静脉窦。手术修复是通过引导冠状静脉窦血流至三尖瓣来进行的。解剖结构的邻近性使得能够进行类似于改良Mustard手术的心房内补片修复。术后患儿出现了2天的心输出量降低,需要使用正性肌力药物支持和机械通气。除此之外,她的恢复过程顺利。术后超声心动图显示修复完整,从肺静脉经补片至右心室的血流良好。术后近2年,患者接受了心导管检查,结果显示手术修复完整,所有心腔压力正常。据我们所知,这是医学文献中关于这种合并情况手术治疗的首例报告。