错过最佳手术时机的永存动脉干的一期矫治  

Repair of truncus arteriosus beyond optimal timing of surgery

作　　者：田良鑫[1] 闫军[1] 罗国华[1] 李守军[1] 

机构地区：[1]中国医学科学院阜外心血管病医院外科,北京100037

出　　处：《心脏杂志》2012年第1期88-89,96,共3页Chinese Heart Journal

摘　　要：目的:总结错过最佳手术时机的永存动脉干一期矫治术结果及经验。方法:2008年6月～2010年7月,我院连续收治14(男6,女8)例永存动脉干患者,年龄0.6～18(4±5)岁,均大于公认的最佳手术年龄。在全麻低温体外循环下行一期矫治术,以牛颈静脉或同种肺动脉带瓣管道连接右心室至肺动脉。结果:术后早期死亡1例。二次开胸1例,术后随访13例,随访时间0.6～2.2(1.6±0.7)年,随访中无死亡。随访期内心功能均较出院时改善。结论:错过最佳手术时机的永存动脉干只要严格掌握适应证,处理肺动脉高压问题,则行一期矫治术成功率高,近期随访结果满意。AIM：To review the experience and outcomes of one-stage repair of truncus arteriosus（TA） in patients who were beyond the optimal time for surgical repair.METHODS：From June 2008 to July 2010,14 patients（6 males and 8 females） underwent one-stage repair of TA with pulmonary hypertension under hypothermia cardiopulmonary bypass.Mean age of the patients was（4±5） years（range 0.6-18 years）.Patients were much older than the generally accepted optimal age for surgical repair.Mean pulmonary artery pressure ranged from 56 to 101 mmHg and right ventricle-pulmonary artery continuity was reconstructed in six patients with a pulmonary homograft conduit and in eight patients using a bovine jugular conduit.RESULTS：There was one in-hospital death and one case requiring reexploration for postoperative bleeding.During a mean follow-up of（1.6±0.7） years,no late deaths occurred and heart functions improved in the 13 survivors.CONCLUSION：Satisfactory outcomes are obtained in patients with TA who have passed the optimal age for surgical repair,using either a pulmonary homograft or a bovine jugular conduit.Long-term follow-up is needed for possible conduit failure or dysfunction.

关 键 词：永存动脉干 肺动脉高压 牛颈静脉带瓣管道 同种肺动脉带瓣管道 

分 类 号：R654.2[医药卫生—外科学]