肺動脈弁下心室中隔欠損を伴う SDL 型両大血管右室起始の1手術例

概要

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A 4-month-old girl with a rare type of double outlet right ventricle (DORV) {situs solitus, D-loop, L-transposition ; S. D. L.} associated with subpulmonic ventricular septal defect (VSD), single coronary arterey, patent ductus arteriosus, left juxtaposition of the atrial appendages and right aortic arch underwent urgent corrective surgery due to sever heart failure. Total correction was as follows. Intraventricular rerouting from the enlarged VSD to the aorta was performed using a Dacron patch. The right ventricular outflow tract was narrowed by this intraventricular tunnel, so an additional right ventricular outflow tract was reconstructed utilizing with an external conduit containing the pericardial bicuspid valves to avoid injury of the right coronary artery across the right ventricular outflow. Postoperative hemodynamics were satisfactory and stable, but she died suddenly of hypoxia on the 2nd postoperative day. The procedure reported on here may be an alternative for correction of this anomaly in an infant. The operative measures for DORV {S. D. L.} were reviewed and discussed.
日本小児外科学会の論文
1992-06-20