Piot J D, Rey C, Serraf A, Touchot A, Lacour-Gayet F, Planché C
Service de chirurgie cardiaque, hôpital Marie-Lannelongue, Le Plessis-Robinson.
Arch Mal Coeur Vaiss. 1998 May;91(5):651-3.
The authors report the case of an 18 month old infant with double-outlet right ventricle and subaortic ventricular septal defect with severe subaortic obstruction. Echocardiography showed the subaortic obstruction to be due to severe hypertrophy of the parietal band which grew upwards to the aortic annulus. A peak instantaneous Doppler gradient of 72 mmHg was recorded between the right ventricle and the aorta. The hypertrophy of the band was secondary to pulmonary artery banding performed in the neonatal period at the same time as cure of an isthmic coarctation of the aorta. Surgical exploration confirmed the echocardiographic findings a circular subaortic muscular stenosis related to hypertrophy of the parietal band. Resection of this band liberated the left ventricular outflow tract and made possible a tunnelisation procedure between the left ventricle and the aorta. Postoperative Doppler echocardiography showed the absence of subaortic stenosis.
作者报告了一例18个月大的婴儿,患有右心室双出口和主动脉下室间隔缺损并伴有严重的主动脉下梗阻。超声心动图显示主动脉下梗阻是由于壁束严重肥厚,该壁束向上生长至主动脉瓣环。右心室与主动脉之间记录到的瞬时多普勒峰值压差为72 mmHg。该束带的肥厚继发于新生儿期在治疗主动脉峡部缩窄的同时进行的肺动脉环扎术。手术探查证实了超声心动图的结果,即与壁束肥厚相关的环状主动脉下肌性狭窄。切除该束带使左心室流出道得以松解,并使得在左心室与主动脉之间进行隧道化手术成为可能。术后多普勒超声心动图显示主动脉下狭窄消失。