Ohuchi H, Nagata N, Okabe H, Koseni K, Itoh K
Department of Thoracic Surgery, Kanagawa Children's Medical Center, Yokohama, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1995 Dec;43(12):1963-6.
One-year-old boy who previously had modified Van Praagh procedure for interruption of the aortic arch (Celoria-Patton type A) and double inlet left ventricle with ventriculoarterial discordance was admitted for progressive cyanosis. He underwent reconstruction of the left pulmonary artery and additional left common carotid-left pulmonary artery shunt. During this procedure, severe hypotension of the lower extremities and heart failure occurred for unknown cause. He died on the 7 postoperative day for lung bleeding with disseminated intravascular coagulopathy. Autopsy revealed dissection of the pseudointima and obstruction of the prosthetic graft (interposed between the main pulmonary artery and the descending aorta). This complication seems very rare but a great care should be taken when a prosthetic graft is manipulated later.
一名1岁男童,此前接受过改良的Van Praagh手术以治疗主动脉弓中断(Celoria-Patton A型)及双入口左心室伴心室动脉不一致,因进行性发绀入院。他接受了左肺动脉重建及额外的左颈总动脉-左肺动脉分流术。在此手术过程中,下肢出现严重低血压且原因不明地发生了心力衰竭。他在术后第7天因肺出血伴弥散性血管内凝血而死亡。尸检显示假内膜剥离及人工血管(置于主肺动脉与降主动脉之间)阻塞。这种并发症似乎非常罕见,但之后在处理人工血管时应格外小心。