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Vascular Ring Due to Double Aortic Arch with Atretic Left Arch and Left Ligamentum Arteriosum: Report of one Case

雙主動脈弓合併左動脈弓閉鎖及左脈導管韌帶所形成的血管環:一病例報告

摘要


一天大女嬰一出生即出現餵奶後嘔吐及呼吸急促的現象。食道攝影顯示食道有明顯的外來壓迫。心臓超音波顯示右主動脈弓合併鏡像血管分枝,且無心臓內異常。心導管檢查與心臓超音波發現相同,另發現左鎖骨下動脈有帳篷樣突出及降主動脈有寇氏肓囊。外科手術發現一完全性血管環壓迫氣管與食道,此環由右主動脈弓,閉鎖的左動脈弓及左動脈導管韌帶所形成,經切除閉鎖的左動脈弓及左動脈導管韌帶,病人的臨床病況顯著改善。

並列摘要


A 1-day-ld female infant presented with vomiting immediately after feeding and shortness of breath after birth. Esophagography revealed external compression of the esophagus. Echocardiography showed a right aortic arch with mirror image branching of brachiocephalic vessels without intracardiac anomalies. Left ventriculography confirmed the echocardiography findings and revealed a tenting of the proximal part of the left subclavian artery and a blind pouch of Kommerell diverticulum at the descending aorta. The patient underwent surgery, which revealed a complete vascular ring compressing the trachea and the esophagus. The ring was formed by a right aortic arch, atretic left arch and left ligamentum arteriosum. Following surgical division of the ligamentum arteriosum and the atretic left arch, the symptoms subsequently improved.

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