同种带瓣管道在复杂先心病外科治疗中的应用  

Homografts for surgical treatment of complexcongenital heart diseases

作　　者：孙宗全[1] 董念国[1] 付平 杜心灵[1] 蒋雄刚[1] 蓝鸿钧[1] 

机构地区：[1]同济医科大学心血管病研究所

出　　处：《临床心血管病杂志》1999年第6期266-269,共4页Journal of Clinical Cardiology

摘　　要：目的：探讨冷冻保存的同种带瓣管道（ＶＨ）治疗复杂先天性心脏病的临床应用价值。方法：采用冷冻保存的ＶＨ为５例完全性大动脉转位和１例Ⅲ型肺动脉闭锁的复杂先心病患者进行外科治疗。１例行右室流出道重建术，２例行Ｄａｍｕｓ手术，３例行Ｒａｓｔｅｌｉ手术。结果：手术死亡１例，术后早期死亡１例，存活的４例中３例术后有较长时间不明原因的低热，经１～１７个月的术后随访，紫绀和症状消失，心功能明显改善。心功能ＮＹＨＡⅠ和Ⅱ级各２例，最后一次彩色多普勒检查提示，１例ＶＨ瓣膜轻度反流，２例ＶＨ内血流速度稍增快。结论：ＶＨ临床应用具有符合人体生理结构、血流动力学性能优良、心内感染发生率低、术后无需抗凝治疗等优点。掌握好ＶＨ的术中裁制和植入的有关技术，选用尽量偏大号的ＶＨ是提高其治疗复杂先心病效果的关键。Objective: The experience of surgical treatment for complex congenital heart diseases with cryopreserved valve homografts was revieved in this report. Method: Five patients with transposition of the great arteries and one patient with type pulmonary artery atresia underwent operation wiht cryopreserved homografts from February 1997 to July 1998.Reconstruction of right ventricular outflow tract was performed in one patient,Damus operation was in two cases and Rastelli operation in three. Result: There was one operative death and one postoperative early death.Of four survival patients,three patients displayed sustained postoperative low fever of unknown origin.Mean followup was 9.3 months (range 1￣17 months).Cardiac function obviously improved,two patients were In New York Heart Association class and another two patients were in .Latest color doppler echocardiographic examination shown there was mild regurgitation in one patient and slightly flow Velocity increase in two patients. Conclusion: In order to improve the surgical effect of complex congenital disease,it is much more important to master the tailoring and transplant technology of valve homograft during operation and select larger diameter valve homograft as well.

关 键 词：先天性心脏病 外科手术 同种带瓣管道 

分 类 号：R654.2[医药卫生—外科学]