大動脈弓離断症 : 術式に関する検討

概要

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Four patients with IAA were treated surgically in our institution. Three patients(case 1, 3 and 4) were diagnosed as type A IAA and the remaining(case 2) was type B IAA. Only case 3 was IAA without pulmonary-ductus-descending aorta(PDDT). All cases were associated with ventricular septal defect(VSD), and Taussig-Bing complex was complicated in case 1. Two patients(case 1 and 2) died during palliative operation because of cardiac failure. Case 3 with type A IAA without PDDT, in which pulmonany artery(PA) banding and anastomosis between left subclavian artery and descending aorta had been performed palliatively, was successfully followed 6 months later by VSD closure and PA debanding. Early two stage operation at the interval of 10 days was performed in case 4 with a good result; ligation of patent ductus arteriosus(PDA) and reconstruction of aortic arch with polytetrafluoro-ethylene graft at first and then VSD closure. In regards to surgical procedures to be chosen for the treatment of IAA, there are some conflicting views. Even after successful radical operation, long term follow up is necessary for early detection of pulmonary hypertension or stenosis of reconstructed part of aortic arch.
日本小児外科学会の論文
1987-02-20