Ono Y, Momokawa T, Shuto K, Munakata M, Suzuki S, Koie H
Department of Cardiovascular Surgery, Aomori City Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Sep;41(9):1595-8.
The patient was a 5 years old male who had had the cyanosis and congestive heart failure from his neonatal period. Dopamine, digitalis and diuretics disappeared his symptoms and he had been followed up as the out-patient. Preoperative cardiac catheterization revealed atrial septal defect and moderately pulmonary stenosis with two-staged systolic pressure gradient in a right ventricular cavity. Right ventriculogram showed subpulmonary crescent-shaped, linear filling defect. Ventricular septal defect was not detected. He was underwent open heart surgery and subpulmonary membranous stenosis was found out. Pressure gradient across the right ventricular outflow tract was diminished by the resection of the membranous structure. Atrial septal defect without lower margin was closed directly. Postoperative course was uneventful. Right ventricular apical systolic pressure was decreased to the degree of 27 mmHg postoperatively.
该患者为一名5岁男性，自新生儿期起即出现紫绀和充血性心力衰竭。多巴胺、洋地黄和利尿剂使症状消失，此后他一直作为门诊患者接受随访。术前心脏导管检查显示房间隔缺损和中度肺动脉狭窄，右心室腔内有两级收缩压梯度。右心室造影显示肺动脉下新月形线性充盈缺损。未检测到室间隔缺损。他接受了心脏直视手术，发现了肺动脉下膜性狭窄。通过切除膜性结构，右心室流出道的压力梯度减小。无下缘的房间隔缺损直接缝合。术后过程顺利。术后右心室尖部收缩压降至27 mmHg。
