高度の肺高血圧症を呈した分画肺を伴わない異常体動脈肺静脈瘻の1乳児治験例

概要

論文の詳細を見る
This paper describes a 6-month-old infant with aberrant systemic artery to pulmonary vein fistula without pulmonay sequestration. The patient had history of recurrent upper respiratory infection and persistent stridor, severe pulmonary congestion and dextroversion of the enlarged cardiac silhouette on the chest roentgenogram. Severe pulmonary hypertension without left-to-right shunt in the pulmonary artery was demonstrated by the cardiac catheterization and the aortogram revealed the two aberrant arteries originating from the descending aorta just below the diaphragm, entering the posterior basal segment of the right lung, branching into many vascular channels and draining promptly into the right pulmonary vein. The bronchogram showed a normal branching of the right bronchi. Ligation and division of the aberrant arteries were carried out successfully and the patient is asymptomatic and has no signs of recurrence 3 years postoperativelly. Only ten similar cases were reported so far in the literatures but none of the cases demonstrated pulmonary hypertension. Our case indicates the possibility of developing pulmonary hypertension in those cases reported and the importance of early diagnosis and surgical treatment before any irreversible pulmonary vascular change might occure.
日本小児外科学会の論文
1984-08-20