Tamaki S, Takagi Y, Mizuno S, Tanaka M, Abe T
Department of Thoracic Surgery, Nagoya University, School of Medicine, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Aug;41(8):1390-3.
A 21-year-old man, who had undergone Fontan operation for tricuspid atresia type 1b using 21 mm Hancock valved conduit 15 years ago, had right sided heart failure when his heart rhythm turned to atrial fibrillation. On cardiac catheterization, pressure data revealed that trans valved conduit pressure gradient reached to 5.2 mmHg. Chest CT and right atrial angiography showed right atrial wall thrombus. Right upper lobe perfusion defect was detected by lung perfusion scintigraphy. Then he was recommended redo Fontan operation. He underwent resection of stenosed valved conduit, right atrial thrombectomy and reconstruction of new route between right atrium and pulmonary artery with bovine pericardium. He tolerated well that operation and now 3 months passed, he resumed fairly vigorous physical activity.
一名21岁男性，15年前因1b型三尖瓣闭锁接受了Fontan手术，使用21毫米Hancock带瓣管道，当他的心律转为心房颤动时出现了右侧心力衰竭。心脏导管检查时，压力数据显示经带瓣管道的压力梯度达到5.2毫米汞柱。胸部CT和右心房血管造影显示右心房壁血栓。肺灌注闪烁显像检测到右上叶灌注缺损。随后他被建议再次进行Fontan手术。他接受了狭窄带瓣管道切除术、右心房血栓切除术，并使用牛心包重建了右心房与肺动脉之间的新路径。他对该手术耐受性良好，现在3个月过去了，他已恢复相当积极的体力活动。
