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KMID : 0367219860030010059
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Sejong Medical Journal
1986 Volume.3 No. 1 p.59 ~ p.66
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A Surgical Experience of Left Atrial Isomerism with Double Outlet Left Ventricle, Pulmonary Stenosis and Anomalous Venous Drainage
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김원곤/Kim, W.K.
김삼현/박영관/김남수/이흥재/최영희/서연림/Kim, S.H./Park, Y.K./Kim, N.S./Lee, H.J./Choi, Y.H./Suh, Y.L.
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Abstract
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A case of complex cardiac anomaly associated with left atrial isomerism is reported. The patient was 15 years old female with cyanosis and dyspnea from six months of age. Bronchial tomography revealed bilateral left sidedness. Levocardia, midline liver,. right sided stomach were present. Clinical evaluation of echocardiography, cardiac catheterization and angiography revealed left atrial isomerism with systemic venous connection to left sided atrium. Pulmonary veins were also connected to the left atrium. Biventricular connection and d-loop, double outlet left ventricle with D-transposition of aorta were pre-sent. A ventricular septal defect of perimembranous and subarterial type, and pulmonary stenosis were associated.
Corrective surgery was performed under extracorporeal circulation and hypothermia. Ventricular septal defect was closed with patch through transverse incision of right ventricular infundibulum. Pulmonic stenosis was releaved by valvotomy, however pressure gradient persisted and external valved conduit was made. Atrial septation to connect pulmonary venous flow to right ventricle was made. The patient died of low cardiac output and myocardial damage due to.the complex operative procedure.
Autopsy was performed and the complex cardiac anatomy, thoracoabdominal situs and polysplenia were confirmed.
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