Tayama M, Miyamoto K, Kuroda O, Nakagawa T, Sugimoto H
Department of Cardiac Surgery, Osaka Children's Medical Center, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Nov;41(11):2234-8.
A 2-month-old male infant with anomalous origin of right pulmonary artery from ascending aorta who had subdural hematoma and MRSA infection due to the hemodynamic deterioration after cardiac catheterization was reported. The cardiac anomaly was successfully corrected by bypass grafting between the right pulmonary artery and the pulmonary trunk with an expanded polytetrafluoroethylene tube. This procedure without cardiopulmonary bypass was selected because of the presence of subdural hematoma and poor general conditions, and no signs of mediastinitis were noticed postoperatively in spite of the use of artificial material. But he had colostomy and drainage due to postoperative intestinal perforation. The complicated postoperative course of this patient recommends us the surgical correction of this anomaly without cardiac catheterization.
报道了一名2个月大的男婴,其右肺动脉起源于升主动脉异常,在心脏导管插入术后因血流动力学恶化出现硬膜下血肿和耐甲氧西林金黄色葡萄球菌感染。通过使用膨体聚四氟乙烯管在右肺动脉和肺动脉主干之间进行旁路移植,成功纠正了心脏异常。由于存在硬膜下血肿且一般状况较差,选择了这种非体外循环手术,尽管使用了人工材料,但术后未发现纵隔炎迹象。但他术后因肠穿孔进行了结肠造口术和引流。该患者复杂的术后病程提示我们对此类异常应避免心脏导管插入术而直接进行手术矫正。