左室大動脈トンネル術後の気管狭窄に対する後方大動脈縫縮法の1例
症例は9カ月男児，胎児診断で左室大動脈トンネルを指摘され，出生後約2時間で緊急左室大動脈トンネルパッチ閉鎖術を施行した．患児は大動脈弁狭窄兼閉鎖不全症も合併しており，術後上行大動脈拡大の進行による気管の圧排，および呼吸器症状の遷延を認めたため，上行大動脈の後方縫縮術を施行した．術後気道圧排所見は消失し呼吸器症状が改善された．気道と隣接する大動脈後面を縮小する後方大動脈縫縮は，吊り上げ術，前方縫縮術，スライド術などに比してより直接的，かつ長期的な圧排回避効果が期待しうる．...
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| Published in | 日本心臓血管外科学会雑誌 Vol. 49; no. 4; pp. 192 - 195 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本心臓血管外科学会
15.07.2020
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0285-1474 1883-4108 |
| DOI | 10.4326/jjcvs.49.192 |
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| Abstract | 症例は9カ月男児，胎児診断で左室大動脈トンネルを指摘され，出生後約2時間で緊急左室大動脈トンネルパッチ閉鎖術を施行した．患児は大動脈弁狭窄兼閉鎖不全症も合併しており，術後上行大動脈拡大の進行による気管の圧排，および呼吸器症状の遷延を認めたため，上行大動脈の後方縫縮術を施行した．術後気道圧排所見は消失し呼吸器症状が改善された．気道と隣接する大動脈後面を縮小する後方大動脈縫縮は，吊り上げ術，前方縫縮術，スライド術などに比してより直接的，かつ長期的な圧排回避効果が期待しうる． |
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| AbstractList | 症例は9カ月男児，胎児診断で左室大動脈トンネルを指摘され，出生後約2時間で緊急左室大動脈トンネルパッチ閉鎖術を施行した．患児は大動脈弁狭窄兼閉鎖不全症も合併しており，術後上行大動脈拡大の進行による気管の圧排，および呼吸器症状の遷延を認めたため，上行大動脈の後方縫縮術を施行した．術後気道圧排所見は消失し呼吸器症状が改善された．気道と隣接する大動脈後面を縮小する後方大動脈縫縮は，吊り上げ術，前方縫縮術，スライド術などに比してより直接的，かつ長期的な圧排回避効果が期待しうる． |
| Author | 村山, 史朗 磯部, 将 野村, 耕司 黄, 義浩 |
| Author_xml | – sequence: 1 fullname: 黄, 義浩 organization: 埼玉県立小児医療センター心臓血管外科 – sequence: 1 fullname: 磯部, 将 organization: 埼玉県立小児医療センター心臓血管外科 – sequence: 1 fullname: 野村, 耕司 organization: 埼玉県立小児医療センター心臓血管外科 – sequence: 1 fullname: 村山, 史朗 organization: 埼玉県立小児医療センター心臓血管外科 |
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| References | 6) Hasegawa T, Oshima Y, Maruo A et al. Aortic arch geometry after the Norwood procedure : the value of arch angle augmentation. J Thorac Cardiovasc Surg 2015 ; 150 : 358-66. 5) An HS, Choi EY, Kwon BS et al. Airway compression in children with congenital heart disease evaluated using computed tomography. Ann Thorac Surg 2013 ; 96 : 2192-7. 2) Torre M, Carlucci M, Speggiorin S et al. Aortopexy for the treatment of tracheamalacia in children : review of the literature. Ital J Pediatr 2012 ; 38 : 62. 4) Doff B, McElhinney V, Reddy M et al. Compression of the central airways by a dilated aorta in infants and children with congenital heart disease. Ann Thorac Surg 1999 ; 67 : 1130-6. 1) Rijnberg FM, Butler CR, Bieli C et al. Aortopexy for the treatment of tracheabronchomalacia in 100 children : a 10-year single-centre experience. Eur J Cardiothorac Surg 2018 ; 54 : 585-92. 7) Barnes JH, Boesch RP, Balakrishnan K et al. Temporary bronchial stenting for airway compression in the interstage palliation of functional single ventricle. Ann Pediatr Cardiol 2019 ; 12 : 308-11. 3) Sakurai H, Nonaka T, Sakurai T et al. Mid-term results of ascending aortic extension and plication technique for narrowing the retroaortic space : five cases. Ped Cardiol Card Surg 2016 ; 32 : 417-22. |
| References_xml | – reference: 2) Torre M, Carlucci M, Speggiorin S et al. Aortopexy for the treatment of tracheamalacia in children : review of the literature. Ital J Pediatr 2012 ; 38 : 62. – reference: 7) Barnes JH, Boesch RP, Balakrishnan K et al. Temporary bronchial stenting for airway compression in the interstage palliation of functional single ventricle. Ann Pediatr Cardiol 2019 ; 12 : 308-11. – reference: 1) Rijnberg FM, Butler CR, Bieli C et al. Aortopexy for the treatment of tracheabronchomalacia in 100 children : a 10-year single-centre experience. Eur J Cardiothorac Surg 2018 ; 54 : 585-92. – reference: 3) Sakurai H, Nonaka T, Sakurai T et al. Mid-term results of ascending aortic extension and plication technique for narrowing the retroaortic space : five cases. Ped Cardiol Card Surg 2016 ; 32 : 417-22. – reference: 4) Doff B, McElhinney V, Reddy M et al. Compression of the central airways by a dilated aorta in infants and children with congenital heart disease. Ann Thorac Surg 1999 ; 67 : 1130-6. – reference: 5) An HS, Choi EY, Kwon BS et al. Airway compression in children with congenital heart disease evaluated using computed tomography. Ann Thorac Surg 2013 ; 96 : 2192-7. – reference: 6) Hasegawa T, Oshima Y, Maruo A et al. Aortic arch geometry after the Norwood procedure : the value of arch angle augmentation. J Thorac Cardiovasc Surg 2015 ; 150 : 358-66. |
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| Snippet | 症例は9カ月男児，胎児診断で左室大動脈トンネルを指摘され，出生後約2時間で緊急左室大動脈トンネルパッチ閉鎖術を施行した．患児は大動脈弁狭窄兼閉鎖不全症も合... |
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| SubjectTerms | 上行大動脈 後方大動脈縫縮術 気管狭窄 気管軟化症 |
| Title | 左室大動脈トンネル術後の気管狭窄に対する後方大動脈縫縮法の1例 |
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