Damus-Kaye-Stansel Anastomosis for Rapid Progression of Subaortic Stenosis after Pulmonary Artery Banding in a Single Ventricle Infant with Aortic Arch Hypoplasia
作者： Hideyuki Kato , Yuji Hiramatsu , Yukiko Ban , Mio Noma , Shinya Kanemoto
DOI: 10.4326/JJCVS.36.284
关键词:
摘要: 肺動脈絞扼術後に急速に進行した大動脈弁下狭窄に対して,早期にDamus-Kaye-Stansel(DKS)吻合術を行って奏効した大動脈弓低形成を伴う単心室症,両大血管右室起始症の1例を報告する.症例は右室型単心室症,僧帽弁閉鎖症,両大血管右室起始症,大動脈弓低形成,心房中隔欠損症および動脈管開存症の新生児.日齢4に拡大大動脈弓形成術と肺動脈絞扼術を行った.生後70日ころからチアノーゼと多呼吸が出現し,強度の大動脈弁下狭窄による著しい肺高血圧と診断された.ただちにDKS吻合術,心房中隔欠損拡大術,右modified Blalock-Taussig手術を行い回復した.本症例のような大動脈弓低形成を伴う単心室症は肺動脈絞扼術後の大動脈弁下狭窄進行に関するハイリスク群であり,第1期手術として肺動脈絞扼術と大動脈弓形成を選択した場合には,早期の大動脈弁下狭窄解除の必要性を念頭において厳重な経過観察を行う必要があると考えられた.
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