PDF(Pubmed)
Abstract：
Congenital heart disease may require multiple cardiac surgeries during childhood. Subsequent non-cardiac surgeries increase the perioperative bleeding and hypoxia because of changes in circulation. An 18-year-old male patient with a history of multiple cardiac interventions, including Fontan surgery, underwent a thoracoscopic right lung suture and coverage for recurrent right spontaneous pneumothorax under general anesthesia with one lung ventilation (OLV). The superior dorsal and inferior lobes, which were inflatable before surgery, failed to expand during leakage testing. The trachea\'s condition was examined using a flexible bronchoscope, and no obstructions were found. A thoracic drainage catheter was inserted, and the lower lobe was dilated from outside the body using negative pressure control in a sealed environment. In the patient with previously treated Fontan circulation, both lungs were expanded by inserting a thoracic catheter during thoracoscopic right lung suture and maintaining negative external pressure.
摘要：
先天性心脏病可能需要在儿童时期进行多次心脏手术。由于循环的变化，随后的非心脏手术增加了围手术期的出血和缺氧。一名18岁的男性患者，有多次心脏介入手术史，包括Fontan手术,在全麻单肺通气（OLV）下，接受胸腔镜右肺缝合并覆盖复发性右自发性气胸。上背和下叶，手术前充气，在泄漏测试期间未能膨胀。使用柔性支气管镜检查气管的状况，没有发现障碍物。插入胸腔引流导管，在密封环境中使用负压控制从体外扩张下叶。在先前接受过Fontan循环治疗的患者中，通过在胸腔镜右肺缝合期间插入胸廓导管并维持外部负压,双肺扩张.
