—侧肺动脉起源于升主动脉

ORIGIN OF ONE PULMONARY ARTERY FROM THE ASCENDING AORTA

我院收治3例一侧肺动脉起源于升主动脉的病例,术前均误诊为单纯室间隔缺损或动脉导管未闭合并肺动脉高压。其中第1例术中心外探查发现左肺动脉起源异常,因当时诊断不甚明确而未行根治术,之后经造影证实为左肺动脉起源于升主动脉合并室间隔缺损。半年后,因肺炎心力衰竭死亡。另外2例术中心外探查诊断为右肺动脉起源于升主动脉,经施行右肺动脉重建术及心内畸形矫治术后,恢复良好出院。本文报告这3例的临床资料,并对其诊断和手术方法作一些讨论。

From Oct. 1990 to July 1992, three patients with origin of one pulmonary artery from the ascending aorta were treated in our hospital. All of the patients were diagnosed as VSD or PDA with pulmonary artery hypertension before operation. The first patient did not receive the operation and died of congestive heart failure six months later. The other two cases were operated on with excellent results. In conclusion, early surgical repair is indicated to correct congestive heart failure and prevent pulmonary vascular obstruction. Reimplantation of the anomalous pulmonary artery is the procedure of choice. The use of a prosthetic conduit for pulmonary artery reconstruction is necessary for adults. Repair should be done with cardiopulmonary bypass for patients with associated intracardiac defect requiring concomitant correction.