合并冠状动脉畸形法洛四联症的外科治疗  

Surgical treatment of Tetralogy of Fallot with anomalous coronary artery

作　　者：何发明[1] 王平凡[1] 梁志强[1] 张力[1] 郑向阳[1] 田振宇[1] 刘延华[1] 

机构地区：[1]河南省胸科医院心血管外科,郑州市450008

出　　处：《中国心血管病研究》2009年第5期367-369,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的总结合并畸形冠状动脉的法洛四联症手术治疗经验，探讨有关技术的改进。方法自2002年1月至2007年12月共完成该类手术18例，其中经右房、肺动脉切口疏通右室流出道7例，改变右室切口4例，主肺动脉移位法2例，双流出道法2例，游离牵开左前降支（LAD）疏通加宽右室流出道（RVOT）2例，1个半心室矫治1例。结果无手术死亡，随访8～82个月，无晚期死亡及并发症发生。结论术中根据右室流出道狭窄程度和畸形冠状动脉走行争取个性化手术方式，疗效满意。Objective To summarize the experience of surgical treatment of Tetralogy of Fallot （TOF） with anomalous coronary artery. Methods From January 2002 to December 2007,18 patients with TOF and anomalous coronary artery underwent surgical repair. To avoid injury of the anomalous coronary arteries, some modified surgical techniques were used. The right ventricle outflow tract was repaired via the right atrium and/or pulmonary incision in 7 patients, displaced ventriculotomy in 4, main pulmonary artery translocation in 2, double right ventricular tract （RVOT） in 2, repaired under a mobilized left anterior descending coronary artery in 2, one and a half ventricular repaired in 1. Results There were no early or late death. Follow-up time was 8 to 82 months, there were no residual leakage and obstruction of RVOT. Conclusion Repair of TOF with anomalous coronary artery can be done with excellent results. The surgeon should undergo the individualized surgical procedures base on the extent of RVOT obstruction and distribution of the anomalous coronary artery.

关 键 词：法洛四联症 冠状动脉畸形 心脏外科手术 

分 类 号：R654.2[医药卫生—外科学]