<原著>心室中隔欠損を伴わない肺動脈閉鎖症の4手術経験

概要

論文の詳細を見る
Pulmonary atresia with intact ventricular septum is one of the rare congenital cardiac malformations and has very poor prognosis. Recently, we performed operation upon four infancy cases with this disease from 46 days to 11 months of age and the results were excellent. Three cases of type II underwent pulmonary valvotomy and a case of type I pulmonary valvotomy and additional aorto-pulmonary shunt operation. To perform pulmonary valvotomy, a small incision was made in the anterior wall of right ventricular inflow tract and a Brock's valvulotome was inserted to incise the atretic pulmonary valve. Further enlargement of the orifice was made with curved fine forceps. To prevent the right ventricular myocardium from deterioration and to improve prognosis, early stage pulmonary valvotomy is effective. Our policy of the treatment for this disease is as follows : 1) for type II, simple pulmonary valvotomy is sufficient to reduce tricuspid insufficiency and obtain sufficient pulmonary flow. 2) for type I, in addition to pulmonary valvotomy, aortopulmonary shunt operation is necessary to obtain sufficient pulmonary blood flow. Additional aortopulmonary shunt depends on preoperative right ventricular volume and compliance, and postvalvotomy arterial O_2 saturation.
近畿大学の論文
1981-12-25