Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Hybrid Palliation for Functionally Single Ventricle with Systemic Outflow Obstruction

단심증에서의 Hybrid 고식술

  • Cho, Won-Chul (Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song, Kwang-Jae (Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jung, Sung-Ho (Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Young-Hwee (Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yun, Tae-Jin (Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 조원철 (울산대학교 의과대학 서울아산병원 소아심장외과) ;
  • 송광재 (울산대학교 의과대학 서울아산병원 소아심장외과) ;
  • 정성호 (울산대학교 의과대학 서울아산병원 소아심장외과) ;
  • 김영휘 (울산대학교 의과대학 서울아산병원 소아심장외과) ;
  • 윤태진 (울산대학교 의과대학 서울아산병원 소아심장외과)
  • Published : 2006.12.05
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Abstract

Hybrid procedure was performed for a thirteen-day-old girl with a functionally single ventricle, who weighed 2.2 kg and had been prematurely born at $32^{+5}$ weeks of gestation. She underwent bilateral pulmonary artery banding using 3.5 mm Gore-Tex graft, ductal stenting using balloon expandable stent, and reverse Blalock-Taussig shunt with 3.5 mm Gore-Tex vascular graft. After discharge, she was followed up for 4 months, and underwent 2nd stage operation(extensive arch reconstruction with Damus-Kaye-Stansel anastomosis, atrial septectomy, bilateral pulmonary artery angioplasty, bidirectional cavopulmonary shunt). She has been followed up for 4 months after the 2nd operation with an excellent clinical condition.

생후 13일, 체중 2.2 kg의 여아가 기능적 단심증으로 하이브리드 술식을 받았다. 환아의 진단은 '삼첨판 폐쇄, 완전 대혈관 전위, 심한 대동맥 축착 및 동맥관 의존형 전신 순환'이었으며, Norwood형의 수술을 시행하기에는 미숙아, 저체중, 괴사성 장염 등 위험인자가 너무 많아서 수술 범위를 최소화 하는 하이브리드 술식을 시행하기로 하고 수술장에서 정중흉골 절개 하에 양쪽 폐동맥 띠조임술, 동맥관 내 스텐트 삽입 및 역행성 Blalock-Taussig 단락술을 시행하였다. 수술 후 복부 팽만 및 유미복수 등 다소 어려운 경과를 보였지만 술 후 33일째 퇴원할 수 있었고 퇴원 후 4개월에는 성공적인 2차 수술을 시행하였다. 환아는 2차 수술 후 4개월째 외래 관찰 중이며 정상 발육을 보이고 있다.

Keywords

References

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