总动脉主干中的交叉肺动脉Cris——对治疗和结果的影响

IF 0.8 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Magdi H. Yacoub , Mohamed Nagy , Hatem Hosny , Ahmed Afifi , Amr El Sawy , Ahmed Mahgoub , Hedaia Abdullah , Soha Romeih , Mahmoud Shehata , Abdelrahman Elafifi
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引用次数: 0

摘要

目的探讨肺总动脉主干近端动脉纵横交错的发生率、类型、病理生理学及其对治疗和预后的影响。方法回顾性分析所有接受Aswan Truncus手术的总动脉干患者,包括术前、术后1年和术后2年通过3D分割模型定义的肺动脉近端分支的起源和走向。结果2019年1月至2022年9月,39名患者(19名男性,年龄1-12个月)接受了Aswan Truncus手术。18例(46%)肺动脉近端呈纵横交错排列。死亡率、ICU和住院时间不受是否存在纵横交错模式的影响。然而,在十字交叉组的手术后,有证据表明右肺动脉有不同程度的扭结和扭曲。这导致了严重的狭窄,需要在不同阶段(1个在ICU期间,另一个在1年后)进行支架植入或再次手术。左肺动脉(Criss-cross 2型)的起源与长动脉导管狭窄分开,需要切除狭窄段,然后与右肺动脉吻合,形成60°的分叉角。结论肺总动脉主干患者肺动脉近端交叉型较为常见。术前诊断和量身定制的修复方法是预防晚期并发症所必需的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Criss-cross pulmonary arteries in common arterial trunk – Implications to management and outcome

Criss-cross pulmonary arteries in common arterial trunk – Implications to management and outcome

Objectives

To investigate the incidence, types and pathophysiology of criss-cross pattern of the proximal pulmonary arteries in common arterial trunk and its influence on management and outcomes.

Methods

Retrospective review of all patients with common arterial trunk who underwent Aswan Truncus Operation with regard to the origin and course of the proximal pulmonary artery branches as defined by 3D segmented models pre, immediately and 1 and 2 years after operation.

Results

Between January 2019 and September 2022, 39 patients (19 males, aged 1–12 months) underwent the Aswan Truncus Operation. 18 patients (46%) had criss-cross arrangement of the proximal pulmonary artery. The mortality, ICU and hospital stay were not affected by the presence or absence of the criss-cross pattern. However, following operation in the criss-cross group, there was evidence of different degrees of kinking and twisting of the right pulmonary artery. This resulted in severe narrowing which required stenting or reoperation at different stages (1 during ICU stay and another after 1 year). Separate origin of the left pulmonary artery (Criss-cross Type 2) from a long stenotic ductus arteriosus required resection of the stenotic segment followed by anastomosis to the right pulmonary artery recreating a 60° angle of bifurcation.

Conclusion

Criss-cross pattern of proximal pulmonary arteries is common in patients with common arterial trunk. Pre-operative diagnosis and tailored approaches of repair are required to prevent late complications.

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来源期刊
International journal of cardiology. Congenital heart disease
International journal of cardiology. Congenital heart disease Cardiology and Cardiovascular Medicine
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