应用改良Fontan手术治疗小儿复杂先心病  

Application of modified Fontan procedure to treatment of children with complicated congenital heart defects

作　　者：孙国成[1] 蔡振杰[1] 万明明[1] 耿斌[1] 程云阁 

机构地区：[1]第四军医大学唐都医院心脏外科,西安710038

出　　处：《第四军医大学学报》1997年第1期66-68,共3页Journal of the Fourth Military Medical University

摘　　要：1993年1月至1995年5月应用心房内板障和全腔-肺动脉连接,右心房-肺动脉连接改良Fontan术式矫治小儿复杂先心病8例.病种包括三尖瓣闭锁3例,二尖瓣闭锁1例,右室双出口2例,单心室1例,矫正型大血管错位合并右室发育不良1例.手术死亡2例.其中1例系严重复杂心内畸形,属高危病例,应改做腔-肺分流术.我们认为全腔-肺动脉连接是较好的术式,严格掌握手术指征、合理选择手术方式、吻合口宽畅无阻及严密术后监护是提高手术疗效的几个要点.From January 1993 to May 1995. modified Fontan operation was applied to 8 children with complicated congenital heart defects, including tricuspid atresia, mitral atresia, double outlets of right ventricle, u-niventricle, corrected transposition of great artery combined with hypoplasia of right ventricle. Atrio-pul-monary connection was used in 6 cases, total cavopulmonary connection in 2 cases. The operative mortality was 25%. It was emphasized that criteria for indication of surgery should be strictly fulfilled! the total cavopulmonary connection minimized the risk of postoperative arrhythmia and pulmonary venous obstruction; each anastomotic orifice must be wide enough; more complicated cardiac defects were considered high risk factors contraindicating a Fontan repair. Bidirectional cavo-pulmonary anastomosis might be a choice.

关 键 词：三尖瓣闭锁 儿童 先天性心脏病 外科手术 

分 类 号：R726.542[医药卫生—儿科]