Mizuno A, Nakamura Y, Takayasu H, Saitoh H
Department of Cardiovascular Surgery, Saitama Children's Medical Center, Japan.
Kyobu Geka. 1993 May;46(5):442-4.
Successful repair of a 8-month-old girl with polysplenia was reported. The cardiovascular anomalies were TAPVC (II b), incomplete ECD, interruption of inferior vena cava with hemiazygos continuation, bilateral superior vena cava, and left superior vena cava draining into the coronary sinus. Cardiopulmonary bypass was established with ascending aortic perfusion and caval cannulation. A left superior vena cava was directly cannulated after establishing partial bypass. In this case the left pulmonary vein drained into the right atrium near the orifice of the coronary sinus, so the atrial septal flap was made and sutured between the orifice of the left pulmonary vein and the coronary sinus in order to avoid late pulmonary vein obstruction. Then, atrium was separated by an intraatrial baffle which was sutured to the atrial septal flap. Recently, it becomes possible to surgical repair of polysplenia syndrome according to the advancements of the diagnostic methods, cardiopulmonary bypass, and the technique of the open heart surgery.
据报道,一名8个月大的多脾综合征女孩成功接受了修复手术。心血管异常包括完全性肺静脉异位连接(II b型)、不完全性心内膜垫缺损、下腔静脉中断伴奇静脉延续、双侧上腔静脉以及左位上腔静脉引流至冠状窦。通过升主动脉灌注和腔静脉插管建立体外循环。在建立部分体外循环后,直接对左位上腔静脉进行插管。在该病例中,左肺静脉在冠状窦口附近引流至右心房,因此制作了房间隔瓣并缝合于左肺静脉口与冠状窦之间,以避免晚期肺静脉梗阻。然后,通过缝合于房间隔瓣的心房内挡板将心房分隔。近来,随着诊断方法、体外循环以及心脏直视手术技术的进步,多脾综合征的外科修复已成为可能。