Ellis-Van-Creveld综合征与先天性心脏异常:普通心房伴房室间隔缺损

S. Sirivella
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引用次数: 0

摘要

背景:以骨骼和关节异常等软骨外胚层发育不良(Ellis-Van Creveld综合征)为身体特征的儿童通常伴有先天性心脏异常。患有Ellis-Van cravad综合征的儿童出现心肺症状,需要进行彻底的心脏学评估,以识别和治疗潜在的先天性心脏异常。目的:对患有Ellis-Van-Creveld综合征的儿童进行体体性污斑评估,以发现相关的先天性心脏异常,并成功修复潜在的心脏病变,以减少心脏相关的发病率,提高患者的生存率。病例介绍:10岁男孩,患有软骨外胚层发育不良(牙齿异常,膝外翻和其他骨骼异常),表现为呼吸困难和发绀。二维超声心动图显示房室管间隔缺损伴房室瓣返流和普通心房。心血管造影显示左心室流出道鹅颈畸形。Qp/Qs为3.4:1,全身动脉血氧饱和度(SaO2)为0.7,总心房O2饱和度为0.7。肺静脉与总心房的连接异常。在体外循环和心脏骤停时进行心房切开术,发现部分房室管室间隔缺损伴共同桥小叶,三尖瓣和二尖瓣室间隔小叶裂,室间交通不完全封闭,共同心房伴高度异常的肺静脉插入,位于腔静脉口前方(8厘米)。在部分房室管间隔缺损修复后,用两片Goertex贴片将总心房分割成肺室和全身静脉室进行心内修复。患者只需要暂时用依那普利减轻负荷;除此之外,患者术后过程顺利。在2年的随访中,儿童无房室瓣膜反流,正常。如何引用这篇论文:Sirivella, S. (2021) Ellis-Van-Creveld综合征和先天性心脏异常:普通心房伴房室管间隔缺损。中华心血管外科杂志,11,133-140。https://doi.org/10.4236/wjcs.2021.1112017收稿日期:2021年10月22日收稿日期:2021年12月26日出版日期:2021年12月29日版权所有©作者与科研出版公司。本作品采用知识共享署名国际许可协议(CC BY 4.0)。http://creativecommons.org/licenses/by/4.0/
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ellis-Van-Creveld Syndrome and Congenital Cardiac Anomaly: Common Atrium with Atrioventricular Canal Septal Defect
Background: Children presenting with physical features of chondro-ectodermal dysplasia (Ellis-Van Creveld syndrome) such as skeletal and joint abnormalities often have concomitant congenital cardiac anomalies. Presence of cardiorespiratory symptoms in children with Ellis-Van Craved syndrome warrants a thorough cardiologic evaluation to recognize and treat underlying congenital heart anomaly. Aim: A child with physical stigmata of Ellis-Van-Creveld syndrome is evaluated to detect an associated congenital cardiac anomaly and accomplish successful repair of the underlying cardiac lesion to reduce the cardiac related morbidity and improve the patient survival. Case Presentation: Ten years old boy with chondroectodermal dysplasia (dental anomalies, genu valgum and other skeletal abnormalities) presented with dyspnea and cyanosis. Cardiac evaluation by 2D echo revealed an atrioventricular (AV) canal septal defect with AV valve regurgitation and a common atrium. Angiocardiography showed a goose neck deformity of the left ventricular outflow tract. The Qp/Qs was 3.4: 1, with systemic arterial oxygen desaturation (SaO2 of 0.7) and O2 saturation in the common atrium was 0.7. The pulmonary venous connections to the common atrium were anomalous. Atriotomy on cardiopulmonary bypass and on a cardioplegic arrest discerned a partial AV canal septal defect with a common bridging leaflet, clefts in septal leaflets of tricuspid and mitral vlalves, an incompletely closed interventricular communication, and a common atrium with highly anomalous pulmonary venous insertions well anterior (8 cm) to vena caval orifices. Intracardiac repair was performed with two patches of Goertex to partition the common atrium into the pulmonary and systemic venous chambers after repair of the partial AV canal septal defect. Patient required only a temporary afterload reduction with enalapril; otherwise patient had an uneventful postoperative course. At a 2-year follow-up, the child was well without AV valve regurgitation and had normal How to cite this paper: Sirivella, S. (2021) Ellis-Van-Creveld Syndrome and Congenital Cardiac Anomaly: Common Atrium with Atrioventricular Canal Septal Defect. World Journal of Cardiovascular Surgery, 11, 133-140. https://doi.org/10.4236/wjcs.2021.1112017 Received: October 22, 2021 Accepted: December 26, 2021 Published: December 29, 2021 Copyright © 2021 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/
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