Lacour-Gayet F, Rey C, Planché C
Service de chirurgie cardiaque pédiatrique, Hôpital Marie-Lannelongue, Le Plessis-Robinson.
Arch Mal Coeur Vaiss. 1996 May;89(5):633-6.
Pulmonary vein stenosis is a rare cardiac disease associated with a disastrous prognosis. Nowadays, it is more often a iatrogenic complication, following neonatal surgical repair of total anomalous pulmonary venous drainage (TAPVD). It is as well a native congenital anomaly. The responsible histologic lesion is an intimal hyperplasia that proliferates to involve the extracardiac segment of the pulmonary veins. This lesion tends to be extremely recurrent following surgical or angioplastic attempts. A new sutureless surgical technique, that tunelizes the pulmonary veins to the left atrium through the pericardium, is described. This method was successfully applied in a 2.5 years old child, presenting with bilateral stenosis of pulmonary veins, following neonatal repair of a TAPVD. The result, controlled 6 months later, by catheterization and angiography was judged satisfactory. This new technique, that has to be confirmed by a longer follow up, may provide a therapeutic answer to this challenging disease.
肺静脉狭窄是一种罕见的心脏疾病,预后不良。如今,它更多是一种医源性并发症,继发于新生儿完全性肺静脉异位引流(TAPVD)的外科修复术后。它也是一种先天性原发性异常。其组织学病变是内膜增生,增生累及肺静脉的心外段。这种病变在手术或血管成形术治疗后极易复发。本文描述了一种新的无缝合手术技术,该技术通过心包将肺静脉与左心房建立隧道连接。此方法成功应用于一名2.5岁儿童,该患儿在新生儿期TAPVD修复术后出现双侧肺静脉狭窄。6个月后通过心导管检查和血管造影进行评估,结果令人满意。这种新技术尚需更长时间的随访来证实,它可能为这种具有挑战性的疾病提供一种治疗方法。