Endoscopic visualisation in the surgical repair of an aorto-left ventricular tunnel in a neonate.

IF 0.9 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Fumiya Yoneyama, Javier Brenes
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引用次数: 0

Abstract

Aorto-left ventricular tunnel is a rare congenital cardiac anomaly characterised by an extracardiac channel connecting the ascending aorta directly to the left ventricle. Surgical repair in neonates poses significant challenges due to the diminutive size and close proximity of critical structures such as the aortic valve and coronary ostia. We report the case of a neonate with an aorto-left ventricular tunnel, mild left ventricular dysfunction, and mild aortic insufficiency who underwent successful surgical repair on the sixth day of life. Following cardiopulmonary bypass initiation and cardioplegic arrest, the ascending aorta was transected for direct visualisation. A 5-mm 0° rigid endoscope was employed intraoperatively, providing high-resolution magnification of the aortic valve, right coronary artery, and tunnel anatomy. The tunnel was closed using an autologous pericardial patch, ensuring preservation of the coronary ostium and aortic valve integrity. Postoperative echocardiography demonstrated good left ventricular function, trivial aortic insufficiency, and no residual shunt. The use of rigid endoscopy significantly enhanced the safety and precision of the repair by allowing accurate anatomical delineation and facilitating patch placement. This case highlights the importance of detailed visualisation in neonatal aorto-left ventricular tunnel repair and underscores the utility of rigid endoscopic technology in complex congenital heart surgery. Endoscopic assistance not only aids intraoperative decision-making but also serves as a valuable tool for surgical education and postoperative review.

手术修复新生儿主动脉-左心室隧道的内镜观察。
主动脉-左心室隧道是一种罕见的先天性心脏异常,其特征是一个直接连接升主动脉和左心室的心外通道。由于新生儿的主动脉瓣和冠状动脉开口等关键结构体积小且靠近,手术修复面临着巨大的挑战。我们报告的情况下,一个新生儿与主动脉-左心室隧道,轻度左心室功能障碍,轻度主动脉不全谁接受成功的手术修复在生命的第六天。在体外循环启动和心搏骤停后,将升主动脉横切以直接观察。术中使用5毫米0°刚性内窥镜,提供主动脉瓣、右冠状动脉和隧道解剖的高分辨率放大。使用自体心包补片关闭隧道,确保冠状动脉开口和主动脉瓣的完整性。术后超声心动图显示左心室功能良好,主动脉不全,无残留分流。刚性内窥镜的使用通过允许准确的解剖描绘和促进贴片放置显着提高了修复的安全性和精度。本病例强调了详细可视化在新生儿主动脉-左心室隧道修复中的重要性,并强调了刚性内窥镜技术在复杂先天性心脏手术中的应用。内镜辅助不仅有助于术中决策,而且可作为外科教育和术后回顾的宝贵工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Cardiology in the Young
Cardiology in the Young 医学-小儿科
CiteScore
1.70
自引率
10.00%
发文量
715
审稿时长
4-8 weeks
期刊介绍: Cardiology in the Young is devoted to cardiovascular issues affecting the young, and the older patient suffering the sequels of congenital heart disease, or other cardiac diseases acquired in childhood. The journal serves the interests of all professionals concerned with these topics. By design, the journal is international and multidisciplinary in its approach, and members of the editorial board take an active role in the its mission, helping to make it the essential journal in paediatric cardiology. All aspects of paediatric cardiology are covered within the journal. The content includes original articles, brief reports, editorials, reviews, and papers devoted to continuing professional development.
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