A New Method of One Stage Correction of Taussig-Bing Anomaly with Interrupted Aortic Arch -1 case report-

대동맥궁 단절을 동반한 Taussig-Bing 기형에서 새로운 일차적 완전 교정술 - 1례 보고 -

  • 정종필 (서울중앙병원 흉부외과학 교실) ;
  • 서동만 (서울중앙병원 흉부외과학 교실)
  • Published : 1997.01.01

Abstract

Taussig-Bing anomaly is infrequently associated with interrupted aortic arch and size discrepancy of great arteries makes it difficult to undergo arch reconstruction and arterial switch operation. A 20-day old male infant was admitted with the diagnosis of Taussig-Bing anomaly with type B Interrupted aortic arch. Multi-organ failure, due to the diminution of ductal flow, was stabilized after 3 weeks of prostaglandin El and controlled ventilatory support. The surgical correction consisted of VSD closure, arterial swtich and extended aortic arch reconstruction. The marked disparity between the hypoplastic ascending aorta and the dilated main pulmonary artery was overcome by constructing distal neoaorta using both native ascending and descending aortic tissue. The patient was extubated on postoperative 2nd day Postoperative catheterization showed no left ventricular outflow obstruction, no intracardiac shunt, and no incompetence of neoaortic valve.

Tausslg-Bing 기형은 드물게 대동맥궁 중단과 병발되며, 이 경우 양대혈관의 크기 가 현저히 달라 대동맥 전환술을 시행함에 어려움이 있다. 생후 20일 된 환아가 상기 진단으로 내원하여, 다장기부전에 대한 3주간의 집중관리 후 수술을 받았다. 수술은 심실중격 결손의 복원, 대동맥 전환술 및 광범위한 대동맥궁형성술로 이루어졌으며, 대혈관들의 크기 차이는 상행 및 하행 대동맥의 절편을 이용하여 원위신대동맥(distal neoaorta)를 형성하므로써 극복하였다. 환아는 큰 문제 없이 회복하였으며, 수술후 시행한 심도자상의 결과도 양호한 상태로 16개월간 추적 관찰중이다.

Keywords

References

  1. Circulation v.38 What is the Taussig-Bing malformation? Van Praagh R
  2. J Thorac Cardiovasc Surg v.93 The surgical anatomy of the Taussig-Bing malformation Stellin G;Zuberbuhler JR;Anderson RH(et al.)
  3. J Thorac Cardiovasc Surg v.95 Early result for anatomic correction of transposition of the great arteries and for double-outlet right ventricle with subpulmonary ventricular septal defect Brawn WJ;Mee RB;ChbB(et al.)
  4. J Thorac Cardiovasc Surg v.94 Transposition of the greate arteries with aortic arch obstruction Pigott JD;Chin AJ;Weiberg PM(et al.)
  5. J Thorac Cardiovasc Surg v.91 Surgical anatomy of the infundubular septum in trasposition of the great arteies with ventricular septal defect Kurosawa H;Van Mierop LH
  6. J Thorac Cardiovasc Surg v.105 Anatomical repair of transposition of great arties with ventricular septal defect and aortic arch obstruction Planche C;Serraf A;Comas JV(et al.)
  7. Ann Thorac Surg v.58 New approach to great vessel reconstruction in transpostion complex with interrupted aortic arch Liddicoat JR;Reddy VM;Hanley FL