Hypoplasia of Trachea with Tracheal Bronchus as a Complication ofSurgical Correction of Tetralogy of Fallot
Hypoplazie trachey s tracheálním bronchem jakopříčina komplikací po korekci Fallotovy tetralogie
Kojenec s Fallotovou tetralogií a hypoplazií anulu pulmonální chlopně, úzkými větvemi plicnice, pravostrannýmaortálním obloukem a levostrannou horní dutou žilou se podrobil korekci ve věku 10 měsíců. Výtokový trakt pravékomory byl rozšířenmonokuspidální transanulární záplatou. Pooperační průběh byl nepříznivě ovlivněn respiračnímikomplikacemi způsobenými tracheálním bronchem a hypoplazií trachey, které předoperačně nebyly diagnostikovány.Extrémní emfyzém pravého horního a středního laloku zásadně zhoršil hemodynamiku. Byly nutnéopakované reoperace. Horní a střední lalok pravé plíce bylo nakonec nutné resekovat, hypoplastickou tracheurekonstruovat perikardiální záplatou a pulmonární homográft musel být implantován do pulmonální pozice. O rokpozději bylo nutné homográft vyměnit a provést plastiku trikuspidální chlopně z důvodů závažné pulmonálnía trikuspidální regurgitatce a dilatace pravé komory, které se vyvinuly v důsledku zvýšeného tlaku v plicním cévnímřečišti. V současné době je pacient tři roky po původní operaci v dobrém klinickém stavu.
Klíčová slova:
vrozená srdeční vada, Fallotova tetralogie, hypoplazie trachey, tracheální bronchus, plastika trachey,kardiochirurgie, komplikace, reoperace, dítě, kojenec.
Authors:
T. Tláskal; P. Vojtovič; H. Bartáková; M. Marková 1; Z. Kabelka 1
Authors‘ workplace:
Dětské kardiocentrum FNM, Praha 1Klinika ušní, nosní, krční 2. LF UK a FNM, Praha
Published in:
Čas. Lék. čes. 2004; : 553-555
Category:
Overview
A 10 months old infant underwent repair of tetralogy of Fallot with hypoplastic annulus of the pulmonary valve,diminutive pulmonary arteries, right aortic arch and left superior vena cava. The right ventricular outflow tract wasreconstructed using a monocusp patch. The postoperative course was unfavourably influenced by respiratorycomplications due to tracheal bronchus and hypoplasia of trachea, which were not diagnosed preoperatively. Extremeemphysema of the right upper andmiddle lobes compromised haemodynamics. Repeated reoperations were required.The upper and the middle lobes of the right lung had to be resected, the hypoplastic trachea reconstructed witha pericardial patch and pulmonary homograft inserted. One year later, homograft had to be replaced and tricuspidannuloplasty performed for pulmonary and tricuspid regurgitation and right ventricular dilatation as a consequenceof increased pulmonary artery pressure. Three years after the original surgery the patient remains in good clinicalcondition.
Key words:
congenital heart disease, tetralogy of Fallot, hypoplastic trachea, tracheal bronchus, patch repair oftrachea, heart surgery, complication, reoperation, child, infant.
Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistArticle was published in
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