関: ノーウッド手術、左心低形成症候群

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 左心低形成症候群：解剖、臨床的特徴、診断hypoplastic left heart syndrome anatomy clinical features and diagnosis [show details]
…underdevelopment of the left heart with significant hypoplasia of the left ventricle (LV) including atresia, stenosis or hypoplasia of the mitral and/or aortic valves, and hypoplasia of the ascending aorta …
2. 房室（AV）管欠損の臨床症状、病態生理、および診断clinical manifestations pathophysiology and diagnosis of atrioventricular av canal defects [show details]
… variant of hypoplastic left heart syndrome. In addition, since the aortic valve and aortic arch are hypoplastic, the presentation may mimic that of other left-sided obstructed… resulting in hypoplasia of the other ventricle and, potentially, the corresponding great vessels. Symptoms vary depending on which ventricle is affected: Left ventricle (LV) – If LV hypoplasia is severe,…
3. 左心不全患者に生じる肺高血圧症pulmonary hypertension in patients with left heart failure [show details]
… Left-sided heart failure (left heart disease [LHD]) is the most common cause of pulmonary hypertension (PH). This form of PH (henceforth described as PH due to left heart disease [PH-LHD]) can occur in …
4. 先天性心疾患女性における妊娠：特定病変pregnancy in women with congenital heart disease specific lesions [show details]
… The fetal risk of heritability of congenital heart disease is presented separately. The major unoperated left-to-right intracardiac shunts that permit… or univentricular heart is a complex congenital cardiac defect with anatomic features that are not amenable to a biventricular repair and include hypoplasia of one ventricle,…
5. 新生児におけるチアノーゼの心臓の原因cardiac causes of cyanosis in the newborn [show details]
… hypoplastic left heart syndrome (HLHS), complex conditions associated with heterotaxy syndromes, or anomalous systemic venous connection (left superior vena cava connected to the left atrium).… underdevelopment of the left-sided chambers and valves Most commonly there is aortic valve atresia, severe mitral valve stenosis, and marked hypoplasia of the left ventricle. In HLHS, right-to-left shunting…

「ノーウッド手術」

　　[★]

英: Norwood operation, Norwood procedure
同: 左心低形成症候群開心姑息術、Norwood手術
関: 左心低形成症候群

左心低形成症候群に対する開心姑息手術。
手術としては、肺動脈を左右の分岐直下で離断し、上行・球部大動脈を拡大して肺動脈の基部と接続し、また人工血管などを用いて右鎖骨動脈(あるいは腕頭動脈)と右肺動脈を接続する。(左心室に導管を立てて左肺動脈に接続する方法もあるらしい)
術前の問題点：動脈管に依存した循環であること。動脈管の閉鎖により代謝性アシドーシス、冠血管灌流不全による心筋虚血、肺動脈血隆三代による心不全。 (SSUR.374)
達成されること：動脈管への依存から脱することができる。肺循環と体循環の血液量を適切に調節できる。右室の圧負荷、容量負荷を軽減でき、持続性全身性のチアノーゼを防ぐことができる。(参考2)