Staged biventricular repair in aortic hypoplasia: the value of intraoperative myocardial perfusion.

Q4 Medicine
Igor E Konstantinov, Natasha Bocchetta, Tyson A Fricke
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引用次数: 0

Abstract

The patient had a hypoplastic aortic arch with coarctation, a right aberrant subclavian artery, a bicuspid aortic valve, a ventricular septal defect and severe long-segment left ventricular outflow tract obstruction. The patient underwent initial univentricular palliation with subsequent biventricular conversion. Initially the patient had a Norwood operation with a Sano conduit at 23 days of age. The operation was performed on a beating heart with full-body perfusion for optimal preservation of heart cardiac function. At 9 months of age, the patient had a biventricular conversion that required ventricular septal defect enlargement and placement of the valve conduit from the right ventricle to the pulmonary artery (i.e. the Yasui procedure). The patient also had recurrent coarctation and left pulmonary artery stenosis; both were repaired with the heart beating to minimize myocardial ischaemic time.

患者的主动脉弓发育不良并伴有共动脉畸形、右锁骨下动脉畸形、主动脉瓣双瓣、室间隔缺损和严重的长段左室流出道梗阻。患者最初接受了单心室姑息治疗,随后转为双心室治疗。最初,患者在出生23天时接受了带有萨诺导管的诺伍德手术。手术是在一个全身灌注的跳动心脏上进行的,以最大限度地保留心脏的心功能。9 个月大时,患者出现双心室转换,需要扩大室间隔缺损,并将瓣膜导管从右心室置入肺动脉(即安井手术)。患者还患有复发性共动脉瘤和左肺动脉狭窄;这两种疾病都是在心脏跳动的情况下进行修复的,以尽量减少心肌缺血时间。
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来源期刊
CiteScore
0.60
自引率
0.00%
发文量
60
期刊介绍: The Multimedia Manual of Cardio-Thoracic Surgery (MMCTS) is produced by The European Association for Cardio-Thoracic Surgery (EACTS). MMCTS is the world’s premier video-based educational resource for cardiovascular and thoracic surgeons; freely accessible - and essential - for all. MMCTS was launched more than ten years ago under the leadership of founding editor Professor Marko Turina. It was Professor Turina’s vision that the European Association for Cardio-Thoracic Surgery (EACTS), already the world-leader in CT surgery education, should take advantage of the Internet’s rapidly improving video publication capabilities and create a new step-by-step manual of surgical procedures. Professor Turina and EACTS agreed that the manual, MMCTS, should be freely accessible to all users, regardless of association membership status, nationality, or affiliation. MMCTS was self-published by EACTS for some years before being transferred to Oxford University Press, which hosted it until the end of 2016. In November 2016, the Manual returned home to EACTS and it has now relaunched in a completely new format. Since its birth in 2005, MMCTS has published some 400 detailed, video-based demonstrations of cardio-thoracic surgical procedures. Tutorials published prior to 2012 have been archived and we are working with the authors of these tutorials to update their work pending republication on the new site. Our mission is to make MMCTS the best online reference for cardio-thoracic surgeons – residents and experienced surgeons alike. Our aim is to include tutorials presenting procedures at both a fundamental and an advanced level. Truly innovative procedures are also included and are identified as such.
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