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【medical-news】新生婴儿心脏暴露进行6小时手术
Infant Born With Heart Outside Body Undergoes 6-Hour Surgery
Wednesday, November 22, 2006
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MIAMI — Using a piece of Gore-Tex fabric to make their repairs, doctors performed corrective surgery on a baby born with his heart outside his chest, and said Wednesday that the youngster should be able to lead a close-to-normal life.
Naseem Hasni underwent surgery to put his heart inside his chest hours after being delivered by Caesarean section Oct. 31 at Holtz Children's Hospital.
He remained in critical but stable condition Wednesday.
"He's not going to be able to play certain kinds of sports where a blow to the sternum to you and me wouldn't be a problem, but in him it would be. So I think some competitive sports are going to be out," said Dr. Eliot Rosenkranz, a cardiothoracic surgeon, "but he's going to be able to participate in other sorts of activities."
He added: "Certainly the goal is as normal a childhood as he can achieve."
Before the surgery, Naseem's heart looked like a peeled plum sitting atop his pink chest, with the aorta diving back underneath the skin. Nevertheless, the heart was beating away normally.
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During the six-hour operation, surgeons first wrapped Naseem's heart in Gore-Tex, then a layer of his own skin, to substitute for his missing pericardium, the sac that encloses the heart. The heart was then slowly eased inside his chest.
The baby was born with an extremely rare congenital defect, ectopia cordis, in which the heart grows outside the body and the chest wall and sternum fail to develop. The defect was spotted in an ultrasound exam in late September after the mother, Michelle Hasni, 33, began feeling unusual movement from the baby.
"He was having hiccups, but it was constantly and it was every day. I wasn't sure what the movement was," the Miami woman said.
Naseem was delivered at 36 weeks, a few days early. Surgeons made a larger incision than normal to ensure that the heart would not be squeezed or touch any part of the womb. Other than the heart defect, Naseem had developed normally: He was 21 inches long and weighed 9 pounds, 2 ounces at birth.
In a few weeks, Naseem will be fitted with a protective piece of plastic to wear over his chest. When he is about 6 months old, surgeons will graft pieces of his own ribs across his chest to create a sternum, or breastbone.
While doctors had not initially been sure that Naseem would survive until Thanksgiving, he could be home with his family as early as Christmas, Rosenkranz said.
Ectopia cordis occurs 5.5 to 7.9 times per 1 million live births, and the survival rate after surgery is less than 50 percent, the boy's doctors said. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 新生婴儿心脏外露接受6小时手术
2006年11月22，星期三
迈阿密—利用一块用于修复的三角形纤维织物，医生对一名心脏在胸腔外的新生儿进行了矫正术，并于周三宣布该婴儿基本可以过上接近正常的生活。
10月31号在Holtz儿童医院经剖宫产术分娩的Naseem Hasni历经了一场将心脏复位回胸腔的手术。
周三他正处于关键但是稳定的状态。
“他将不能参与一些体育运动，对你我来说，胸骨遭受一次撞击不会有什么问题，但对他来说就可能是。所以我认为应该禁止他参加一些竞技性的运动，”一位心胸外科医生Eliot Rosenkranz说道，“但是其他的运动还是可以参与的”
他继续补充道：“当然目标是尽力像正常的孩童那样度过其儿童期。”
在手术前，Naseem的心脏在他粉红的胸上面立着仿佛一个剥了皮的梅，皮肤底下的主动脉向背部延伸。虽然如此，心脏还是能正常地跳动。
在六小时手术中，外科医师用三角纤维扳包住Naseem的心脏，用来自他自身的一块皮肤来代替包裹心脏的心包膜。然后缓慢把心脏复位回胸腔。
Naseem的心异位是一种罕见的先天性缺陷，心脏长在体外，胸壁和胸骨发育受阻。其母亲33岁的Michelle Hasni，在九月底开始感觉到不正常的胎动，遂经B超证实了这种先天性缺陷。
这位迈阿密的母亲说：“胎儿总打嗝，天天如此，我也不清楚胎动是怎么回事。”
Naseem在36周时分娩，微微早产了一些。手术医师作了比常规更大的切口，以保心脏不被挤压或接触到子宫壁。除了心脏缺陷，Naseem出生时其他都正常：高21英寸，重9磅2盎司。
术后的几周内，Naseem必须穿为他量身做的一片塑胶来保护胸部。等到六个月大，外科医生将用Naseem自身的肋骨通过嫁接构建胸骨。
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作者:admin@医学,生命科学 2011-02-25 17:11
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