同种带瓣主动脉片修补心内分流合并重度肺动脉高压  

Application of Allograft Valved Aortic Patch in the Management of Intracardiac Shunt with Severe Pulmonary Hypertension

作　　者：梁家立[1] 李守先[2] 张广福[1] 姜冠华[1] 

机构地区：[1]济南军区总医院心外科,济南250031 [2]山东大学齐鲁医院心外科,济南250012

出　　处：《中国胸心血管外科临床杂志》2002年第2期81-83,共3页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的　探讨同种带瓣主动脉补片在治疗先天性心脏病重度肺动脉高压中对右心功能的保护作用。方法　自 1998年 5月至 2 0 0 1年 5月应用同种带瓣主动脉补片修补先天性心脏病重度肺动脉高压患者心内缺损 10例。平均肺动脉压 5 5～ 98mm Hg( 1k Pa=7.5 mm Hg) ,平均 72 .4 6± 12 .4 1mm Hg。动脉血氧饱和度 0 .87～ 0 .95 ,平均 0 .91± 0 .0 3。　结果　术后 4 8小时内均顺利脱机 ,无死亡。随访 3～ 2 8个月 ,平均 10 .3± 4 .2个月 ,活瓣均已关闭 ;平均肺动脉压2 0～ 4 8mm Hg,平均 3 6.3 7± 9.66mm Hg;动脉血氧饱和度 0 .95～ 0 .98,平均 0 .97± 0 .0 1;临床症状明显改善。Objective To study the protection of allograft valved aortic patch to right heart function in the treatment of congenital heart diseases with severe pulmonary hypertension. Methods From May 1998 to May 2001 ,10 patients with congenital heart diseases and severe pulmonary hypertension were operated to close the intracardiac septal defects using an allograft valved aortic patch. Mean pulmonary artery pressure was from 55 to 98 mmHg(mean,72.46±12.41 mmHg), arterial oxygen saturation ranged from 0.87 to 0.95(mean,0.91±0 03). Results All patients survived the operation and were weaned from ventilator support within 48 hours after operation. There was impressive improvement in symptoms after operation during the 3 to 28 months(mean, 10.3±4.2 month) follow up period, all unidirectional flap valves were closed, mean pulmonary artery pressure was from 20 to 48 mmHg(mean,36.37±9.66 mmHg), arterial oxygen saturation ranged from 0.95 to 0.98(mean,0.97±0.01). Conclusion The allograft valved aortic patch is useful for management of patients with severe pulmonary hypertension and prevent the right heart failure postoperatively.

关 键 词：心内分流 并发症 同种带瓣主动脉补片 重度肺动脉高压 右心功能 

分 类 号：R654.2[医药卫生—外科学]