Sudoh Y, Takahara Y, Sunazawa T
Division of Cardiovascular Surgery, Funabashi Municipal Hospital, Chiba, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1997 May;45(5):764-8.
A five-year-old boy was admitted to our hospital because of a cardiac murmur and an abnormal electrocardiogram. He had a distinct pattern of facial features and mild mental and developmental retardation. An aortogram revealed that the aorta was hypoplastic from just above the Valsalva sinuses to the aortic arch. Moreover, the basal portions of the arch vessels were also hypoplastic. A diagnosis of diffuse supravalvular aortic stenosis was made. The pressure gradient between the left ventricle and the descending aorta was 74 mmHg on catheter examination. Surgical therapy was therefore indicated. The hypoplastic lesions of the aorta and arch vessels were enlarged with a Dacron patch under cardiopulmonary bypass and deep hypothermic circulatory arrest. The postoperative course was uneventful. The pressure gradient decreased to 7 mmHg on catheter examination. This type of supravalvular aortic stenosis is quite rare. Further follow-up is required to evaluate long-term outcome.
一名五岁男孩因心脏杂音和心电图异常入院。他有独特的面部特征模式,伴有轻度智力和发育迟缓。主动脉造影显示,主动脉自瓦尔萨尔瓦窦上方至主动脉弓发育不全。此外,弓状血管的基部也发育不全。诊断为弥漫性瓣上主动脉狭窄。导管检查显示左心室与降主动脉之间的压力梯度为74 mmHg。因此需要进行手术治疗。在体外循环和深低温停循环下,用涤纶补片扩大主动脉和弓状血管的发育不全病变。术后过程顺利。导管检查显示压力梯度降至7 mmHg。这种类型的瓣上主动脉狭窄非常罕见。需要进一步随访以评估长期结果。