Thoracoscopic management of double aortic arch malformation in infants
10.3760/cma.j.cn112434-20190909-00310
- VernacularTitle:胸腔镜治疗婴幼儿双主动脉弓畸形
- Author:
Zhengbing YANG
1
;
Libing ZHANG
;
Chunlong ZHOU
Author Information
1. 电子科技大学附属妇女儿童医院 成都市妇女儿童中心医院小儿外科一病区 611731
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2020;36(8):458-460
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the effect of thoracoscopy for infants with double aortic arch malformation.Methods:The clinical data of 10 infants with double aortic arch malformation from January 2015 to May 2019 were retrospectively summarized, including 7 boys and 3 girls aged from 2 hours to 8 months, 9 with right arch dominance and 1 with left arch dominance. MRI examination was performed at 35 weeks before birth to understand the relationship between vascular ring and trachea and esophagus. Postnatal surgery was performed when trachea compression exceeded one third, and selective operation was performed around six months after birth if the compression was less than one third.Results:All the 10 cases underwent thoracoscopic surgery, and 1 case underwent thoracotomy because oxygen saturation could not be maintained. The operation time was 80-135 minutes, with an average of 100 minutes. Intraoperative bleeding was about 5-10 ml. Postoperative ventilator support time was 4-14 days. 1 patient was cured and discharged except that he gave up treatment for economic reasons. Postoperative follow-up period was 1-6 months. No difficulty in eating, no difficulty in breathing required tracheal stenosis surgery again. 4 patients needed ventilator support for more than 7 days, 2 patients developed pneumothorax and were cured after drainage. One patient presented hoarseness.Conclusion:Prenatal examination can improve the diagnosis rate of double aortic arch deformity, early intervention follow-up in pediatric surgery can reduce the incidence of related complications in children, and thoracoscopic surgery is feasible to correct the deformity, with small trauma and Less bleeding.
