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"在外流通道的 en-Bloc 旋转后复杂的大动脉门修复" - 案例报告

Rapagnani Andrea¹, El Khoury Gebrine¹, Momeni Mona²

¹Department of Cardiothoracic and Vascular Surgery, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.

Interdisciplinary cardiovascular and thoracic surgery

|October 10, 2025

概括

复杂心脏缺陷的En-bloc旋转手术可能导致大动脉反. 这个案例突出了一个孩子需要大动脉门修复手术后三年,强调早期检测和干预这种并发症.

科学领域:

心脏病学心脏病学
儿科心脏手术儿科心脏手术
遗传性心脏病是一种先天性心脏病.

背景情况:

En-bloc旋转是一种手术技术,用于复杂的先天性心脏缺陷,如TGA与VSD和LVOTO.
之前的一项研究报告说,16%的患者在En-bloc旋转后出现中度大动脉反 (AR).
在这种程序后引起AR的机制尚未完全理解.

研究的目的:

在En-bloc旋转手术后几年内报告一个显著的AR病例.
为了突出这些患者对AR进展的监测的重要性.
讨论AR后En-bloc旋转的潜在管理策略.

主要方法:

一个病例报告,一个4岁的病人接受了En-bloc旋转.
详细的心声回声检查结果显示AR的进展和左心室扩张.
描述大动脉的修复程序,包括LVOT plication和annuloplasty.

主要成果:

该患者在手术后三年发展了3+/4级AR和左心室扩张.
大动脉的修复导致在放电时轻度至中度的残留AR (1+/4) .
在修复后的7个月内,AR仍然是中度的 (2+/4) 与稳定的LV尺寸.

结论:

在En-bloc旋转手术几年后,可能会出现显著的AR.
早期检测和干预对于在这种患者群体中管理AR至关重要.
需要进一步的研究来确定风险因素,并优化手术技术以预防AR.

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