成功分阶段解剖修复先天性房室瓣膜反流的转位一例。

IF 0.4
Yuji Fuchigami, Koichi Toda, Akinori Hirano, Ryusuke Hosoda, Yukino Iijima, Takaya Hoashi
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引用次数: 0

摘要

一名4岁男孩,先天性纠正大动脉转位,肺动脉瓣狭窄,室间隔缺损,表现为进行性低氧血症和轻度至中度二尖瓣和三尖瓣反流。心脏磁共振成像显示右心室容量不足,适合Senning-Rastelli型解剖修复。考虑到手术风险升高与二尖瓣返流和心室容量不足相关,在2岁时进行了最初的姑息治疗,包括全身到肺分流放置和二尖瓣修复,这改善了氧合并促进了右心室生长,二尖瓣返流轻微。随后的影像学证实心室发育充分,二尖瓣轻微反流,允许在4岁和7个月大时进行最终的解剖修复。该手术包括Senning心房开关和Rastelli手术。术后过程顺利,影像学显示双心室功能保留,房室瓣膜返流极少,无流出物或通道阻塞的证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Successful staged anatomic repair for congenitally corrected transposition with both atrioventricular valves' regurgitation: a case report.

A 4-year-old boy with dextrocardia, congenitally corrected transposition of the great arteries, pulmonary valve stenosis, and ventricular septal defect demonstrated progressive hypoxemia and mild-to-moderate mitral and tricuspid regurgitation. Cardiac magnetic resonance imaging revealed insufficient right ventricular volume for Senning-Rastelli type anatomical repair. Given the elevated surgical risk associated with mitral regurgitation and inadequate ventricular volume, an initial palliative approach was undertaken at 2 years of age, consisting of systemic-to-pulmonary shunt placement and mitral valve repair, which improved oxygenation and promoted right ventricular growth, with trivial mitral regurgitation. Subsequent imaging confirmed adequate ventricular development and trivial mitral regurgitation, allowing for definitive anatomic repair at 4 years and 7 months of age. The procedure comprised a Senning atrial switch combined with a Rastelli operation. The postoperative course was uneventful, and imaging demonstrated preserved biventricular function with minimal atrioventricular valve regurgitation and no evidence of outflow or pathway obstruction.

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