Yasuda H, Kado H, Imoto Y, Asou T, Shiokawa Y I, Yasui H
Department of Cardiovascular Surgery, Fukuoka Children's Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1996 Oct;44(10):1907-11.
Staged operation was successfully performed in an infant with bilateral ductus arteriosus, and absence pulmonary artery. The first stage operation was performed at 2 months old of age. The left pulmonary artery was reconstructed using an equine pericardial roll sized 10 mm in diameter, and a 5 mm Dacron graft was anastomosed between the left subclavian artery and the roll as an aortopulmonary shunt. In the second stage, the same procedure was done on the right side at eight months of age. In the last stage, the patient underwent Rastelli procedure at 2 years old of age. The central pulmonary artery was created with a ring forced EPTFE graft above the ascending aorta, and a Carpentier-Edwards valved conduit (14 mm) was anastomosed between the right ventricle and the EPTFE graft. Post operative course was uneventful. We consider that the staged procedure including the pulmonary artery reconstruction and the aortopulmonary shunt on both sides is recommended in the case of absent central pulmonary artery in infant.
一名患有双侧动脉导管未闭且肺动脉缺如的婴儿成功接受了分期手术。第一期手术在患儿2个月大时进行。使用直径10毫米的马心包卷重建左肺动脉，并在左锁骨下动脉与该心包卷之间吻合一段5毫米的涤纶移植物作为体肺分流。第二期手术在患儿8个月大时对右侧进行了相同操作。最后一期手术在患儿2岁时进行了Rastelli手术。在升主动脉上方用带环强制膨体聚四氟乙烯（EPTFE）移植物构建中央肺动脉，并在右心室与EPTFE移植物之间吻合一个Carpentier-Edwards带瓣管道（14毫米）。术后过程顺利。我们认为，对于婴儿中央肺动脉缺如的情况，建议采用包括双侧肺动脉重建和体肺分流的分期手术。
