Inoue T, Wakaki N, Oku H
Department of Cardiovascular Surgery, Kinki University School of Medicine, Osaka, Japan.
Jpn J Thorac Cardiovasc Surg. 1998 Aug;46(8):757-61. doi: 10.1007/BF03217816.
The patient was a 74-year-old man who was complained cyanosis and shortness of breath on exertion. He had undergone open mitral commissurotomy for mitral stenosis 19 years previously. He was diagnosed with mitral stenosis and regurgitation combined with pulmonary arteriovenous fistula (PAVF). Moderate pulmonary hypertension was also observed. It appeared that the PAVF was located where one-step operation with open heart surgery was anatomically feasible, and that his condition would be improved by resection of the fistula and decreasing overload of left atrium by mitral valve replacement. One-step operation including mitral valve replacement and tricuspid annuloplasty with enuculation of the PAVF was therefore performed. The patient has done well postoperatively, and postoperative cardiac catheterization revealed no increase in pulmonary arterial pressure.
该患者为一名74岁男性，主诉有发绀及劳力性呼吸急促。他19年前因二尖瓣狭窄接受了二尖瓣直视交界切开术。他被诊断为二尖瓣狭窄并反流合并肺动静脉瘘（PAVF）。还观察到中度肺动脉高压。看起来该肺动静脉瘘的位置在解剖学上可行心脏直视一步手术，并且通过切除瘘管和二尖瓣置换减轻左心房负荷可改善他的病情。因此，实施了包括二尖瓣置换、三尖瓣环成形术及肺动静脉瘘摘除术的一步手术。患者术后恢复良好，术后心导管检查显示肺动脉压未升高。
