Hypoplazie trachey s tracheálním bronchem jakopříčina komplikací po korekci Fallotovy tetralogie

Hypoplasia of Trachea with Tracheal Bronchus as a Complication ofSurgical Correction of Tetralogy of Fallot

A 10 months old infant underwent repair of tetralogy of Fallot with hypoplastic annulus of the pulmonary valve,diminutive pulmonary arteries, right aortic arch and left superior vena cava. The right ventricular outflow tract wasreconstructed using a monocusp patch. The postoperative course was unfavourably influenced by respiratorycomplications due to tracheal bronchus and hypoplasia of trachea, which were not diagnosed preoperatively. Extremeemphysema of the right upper andmiddle lobes compromised haemodynamics. Repeated reoperations were required.The upper and the middle lobes of the right lung had to be resected, the hypoplastic trachea reconstructed witha pericardial patch and pulmonary homograft inserted. One year later, homograft had to be replaced and tricuspidannuloplasty performed for pulmonary and tricuspid regurgitation and right ventricular dilatation as a consequenceof increased pulmonary artery pressure. Three years after the original surgery the patient remains in good clinicalcondition.

Key words:
congenital heart disease, tetralogy of Fallot, hypoplastic trachea, tracheal bronchus, patch repair oftrachea, heart surgery, complication, reoperation, child, infant.