降主动脉-升主动脉吻合术矫治婴儿期主动脉缩窄合并心内畸形15例  

Descending aorta to ascending aorta anastomoses in treatment of infantile coarctation of aorta with intracardiac malformation in 15 patients

作　　者：陈振良[1] 翟波[1] 王鹏高[1] 张永红[1] 陈忠建[1] 

机构地区：[1]郑州市儿童医院胸心外科,郑州450052

出　　处：《河南外科学杂志》2016年第2期3-5,共3页Henan Journal of Surgery

摘　　要：目的探讨降主动脉-升主动脉吻合术治疗婴儿期主动脉缩窄合并主动脉弓发育不良及心内畸形的疗效。方法选取2011-05—2015-05间治疗的主动脉缩窄合并主动脉弓发育不良、心内畸形的患儿15例。患儿均采用胸骨正中切口、开胸后先游离出主动脉弓、头臂干、动脉导管、弓降部等血管。建立体外循环、选择性脑灌注下行降主动脉-升主动脉端侧吻合术,恢复全身灌注后完成心内畸形的矫治。体外循环时间86~132 min,主动脉阻断时间51~94 min。结果术后早期死亡2例,低心排出量综合征6例,室上性心动过速6例,肺炎7例。13例患儿随访2个月~3 a,无死亡及再次主动脉狭窄。结论降主动脉-升主动脉吻合术治疗婴儿期主动脉缩窄合并主动脉弓发育不良及心内畸形的临床效果满意。Objective To investigate the effect of descending aorta and ascending aorta anastomosis in the treatment of infantile coarctation of the aorta with aortic arch hypoplasia and intracardiac malformation. Methods From May 2011 to May 2015,15 patients with coarctation of the aorta associated with aortic arch hypoplasia and intracardiac malformation. All children were treated with median sternotomy. After cut through the chest,free from aorta,brachiocephalic trunk,PDA,arch and descending aorta and other blood vessel. By end to side anastomosis to connect descending aorta and ascending aorta after establishment of extracorporeal circulation and selective cerebral perfusion. then,Complete correction of intracardiac malformation after restoring blood perfusion. Cardiopulmonary bypass time 86 ~ 132 min,aortic cross clamp time 51 ~ 94 min. Results There are 2 cases of early postoperative death,6 cases of low cardiac output syndrome,6 patients with supraventricular Heartbeat tachycardia and 7 cases of pneumonia. 13 patients were followed up from 2 months to 3 years,no death and restenosis of aorta.Conclusion There is a satisfactory curative effect for descending aorta to ascending aorta anastomoses in the treatment of infantile coarctation of the aorta with aortic arch hypoplasia and intracardiac malformation.

关 键 词：降主动脉 升主动脉 主动脉缩窄 婴儿期 

分 类 号：R654.2[医药卫生—外科学]