乳児期大動脈縮窄症・大動脈弓離断症に対する外科治療

概要

論文の詳細を見る
Sixteen infants with coarctation of the aorta (CoA) and ten infants with interruption of the aortic arch (IAA) under 12 months of age underwent urgent repair during the recent 10 year-period untill December 1985. Nine infants (34.6%) were in newborn period at operation, 9 (34.6%) under 3 months, 4 (15.4%) under 6 months and 4 (15.4%) under 12 months of age. Subclavian fllap method was performed in 7 (1 death), end-to-end anastomosis in 6 (2) and Blalock-Park shunt in 2 (1) infants with coarctation of the aorta. In seven infants associated with CoA and VSD+PH, one-staged correction of CoA and VSD was performed in one (1) and staged corection in 6 (1). In staged operation 4 (1) had undergone VSD closure on urgency and 2 had on elective basis, followed by CoA repair. Van Praagh operation was performed in 7 (3 early deaths, 1 late death) and Blalock-Park shunt in 3 (3) infants with interruption of the aortic arch. Infants admitted with CoA and IAA in congestive heart failure should have prompt surgical intervention after initial medical treatment and complete evaluation by echocardiography and radioisotope injection method. Subclavian flap or end-to-end anastomosis is considerd the procedure of choice in infants with CoA. Indication for Van Praagh operation should be restricted to the cases with hypoplasia of the ascending aorta or aortic arch.
日本小児外科学会の論文
1987-06-20