一名患有严重二尖瓣返流的儿童意外发现 ALCAPA:病例研究。

IF 0.7 Q3 Medicine
Budi Rahmat, Radityo Prakoso, Rafles Ph Simbolon, Albert T Lopolisa, Muhammad Rayhan, Eva M Marwali
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引用次数: 0

摘要

病例报告一名六岁儿童五年前曾接受过心脏手术,现因严重的二尖瓣返流来我院就诊。在目前的手术中,她的冠状动脉在试图松解广泛的心外膜粘连时受伤,导致收缩力极差,从而延误了预定的瓣膜修复手术。受伤的冠状动脉已成功修复,但围术期护理期间仍存在低心输出量综合征,因此有必要进一步检查冠状动脉问题。后来发现患者患有肺动脉左冠状动脉异常(ALCAPA)综合征:讨论:严重二尖瓣反流、肺动脉高压和解剖学因素可能是导致该病例延迟出现和诊断的原因。二尖瓣反流的严重程度和最可能的潜在机制表明,单靠冠状动脉修补术恢复的可能性很低,因此需要同时进行二尖瓣手术。该患者接受了冠状动脉和二尖瓣修复术,结果良好:结论:ALCAPA的治疗面临独特的挑战,尤其是在诊断延迟的病例中。正确的诊断和有针对性的手术方法是ALCAPA患者获得良好预后的关键。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Accidental finding of ALCAPA in a child with severe mitral regurgitation: A case study.

Case report: A six-year-old child who had undergone cardiac surgery five years ago presented to us with severe mitral valve regurgitation. During her current surgery, the coronary artery was injured during the attempt to release extensive epicardial adhesion, resulting in very poor contractility that prompted a delay in the intended valve repair. The injured coronary vessels were successfully repaired, yet low cardiac output syndrome persisted during perioperative care, necessitating further investigation of the coronary problem. It was later discovered that the patient had anomalous left coronary artery from pulmonary artery (ALCAPA) syndrome.

Discussion: The presence of severe mitral regurgitation, pulmonary hypertension, and anatomical factors may have contributed to the delayed presentation and diagnosis in this case. The severity of mitral regurgitation and the most likely underlying mechanism indicates a low possibility of recovery following coronary repair alone, warranting the need for concomitant mitral surgery. Coronary and mitral repair were performed in this patient, resulting in a favorable outcome.

Conclusions: The management of ALCAPA presents unique challenges, especially in cases with delayed diagnosis. Proper diagnosis and tailored surgical approaches are crucial for achieving favorable outcomes in patients with ALCAPA.

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来源期刊
CiteScore
1.30
自引率
0.00%
发文量
78
期刊介绍: The Asian Cardiovascular and Thoracic Annals is an international peer-reviewed journal pertaining to cardiovascular and thoracic medicine. Besides original clinical manuscripts, we welcome research reports, product reviews, reports of new techniques, and findings of special significance to Asia and the Pacific Rim. Case studies that have significant novel original observations, are instructive, include adequate methodological details and provide conclusions. Workshop proceedings, meetings and book reviews, letters to the editor, and meeting announcements are encouraged along with relevant articles from authors.
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