Okabe H, Nagata N, Kaneko Y, Kobayashi J, Kanemoto S
Department of Thoracic and Cardiovascular Surgery, Kanagawa Children's Medical Center, Yokohama, Japan.
Kyobu Geka. 1998 Mar;51(3):222-5.
A 7-year-old boy was admitted for RVOT restenosis. The patient was born following an unremarkable pregnancy and delivery. He was carried out Jatene's procedure for TGA at 23rd day after birth. At 19 month of age, he was removed pulmonary stenosis using patch angioplasty with mono cusp. When he was 6 year of age, the onset of edem, ascites and hepatomegaly were pointed out. At 7 year of age, he was admitted for edema, hypoproteinemia and protein loosing enteropatchy. After he was treated medical therapy, cardiac catheterization showed markedly right atrial and right ventricular hypertension and ventricular septal defect (VSD). Cine angiography suggested the right ventricular outflow tract stenosis, pulmonary valve and tricuspid valve insufficiency. On August 1, 1996, the patient underwent surgical repair: direct closure of VSD, aortic homograft (20mm) replacement for RVOT stenosis and tricuspid valve annuloplasty by DeVega's procedure. Postoperative course was uneventful. At 23rd postoperative day, cardiac catheterization and cine angiography showed no problems. He was not treated with anticoagulation.
一名7岁男孩因右心室流出道再狭窄入院。该患者出生时妊娠和分娩过程均正常。他在出生后第23天接受了动脉调转术治疗大动脉转位。19个月大时，他接受了单瓣补片血管成形术治疗肺动脉狭窄。6岁时，出现水肿、腹水和肝肿大。7岁时，因水肿、低蛋白血症和蛋白丢失性肠病入院。经过药物治疗后，心脏导管检查显示明显的右心房和右心室高压以及室间隔缺损（VSD）。电影血管造影显示右心室流出道狭窄、肺动脉瓣和三尖瓣关闭不全。1996年8月1日，患者接受了手术修复：直接关闭室间隔缺损、用20mm主动脉同种异体移植物置换右心室流出道狭窄并通过德维加手术进行三尖瓣环成形术。术后过程顺利。术后第23天，心脏导管检查和电影血管造影显示无问题。他未接受抗凝治疗。
