- 期刊
Conversion of Fontan Operation to Extracardiac Conduit Cavopulmonary Connection: Report of a Case
Fontan術後轉為腔靜脈肺動脈心外管路術：病例報告
摘要
這位11歲女孩，是一例三尖瓣閉鎖、心室中膈缺損、心房中膈缺損及肺動脈狹窄患者。4歲時接受改良式Fontan氏手術，術後逐漸出現運動耐受力不足、食慾不振及肝臟腫大現象。心導管檢查顯示左肺動脈阻塞、右肺動脈壓力大於30毫米汞柱、右心房嚴重擴大及下腔靜脈腫脹，血氧濃度只有87%。手術治療包括：拆除右心房肺動脈接口、心房中膈切除，使用22 mm人工血管施行心外腔靜脈肺動脈連結及使用10 mm人工血管連接左右肺動脈；術後肺動脈壓力下降至14毫米汞柱，血氧濃度昇至大於95%。經過12個月追蹤，肝臟腫大現象緩解，心臟功能回復到第一級。
關鍵字
無資料並列摘要
This 11-year-old girl underwent a modified Fontan operation at the age of 4 years due to tricuspid atresia Ib, ventricular septal defect, atrial septal defect, and mild pulmonary arterial stenosis. Subsequently, she had problems with progressive exercise intolerance, poor appetite and hepatomegaly after the Fontan operation. Cardiac catheterization showed left pulmonary arterial occlusion with right pulmonary arterial pressure over 30 mmHg, severe right atrial dilatation, and inferior vena cava engorgement. In addition, O2 saturation was only 87%. Surgical intervention was elected because of impending Fontan failure. Operation was performed with take- down of previous atriopulmonary connection, atrial septectomy, total extracardiac cavopulmonary anastomosis with a 22mm polytetrafluoroethylene graft, and interposition of the left pulmonary artery and right pulmonary artery with a 10mm politetrafluoroethylene graft. The pulmonary arterial pressure was 14 mmHg and O2 saturation increased to more than 95% after the operation. During follow-up of 12 months, hepatomegaly subsided and New York Heart Association class I was noted.
延伸閱讀
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