主动脉弓滑动成形术治疗婴幼儿主动脉缩窄并主动脉弓发育不良  

Clinical outcome of aortic arch sliding aortoplasty for surgical repair of coarctation of the aorta and hypoplastic aortic archin infants

作　　者：蒙强[1] 易蔚[1] 金振晓[1] 刘洋[1] 段维勋[1] 梁洪亮[1] 李婷[1] 孙国成[1] 朱海龙[1] 俞世强[1] 易定华[1] 

机构地区：[1]第四军医大学西京医院心血管外科,陕西西安710032

出　　处：《中国体外循环杂志》2016年第2期68-72,共5页Chinese Journal of Extracorporeal Circulation

基　　金：陕西省国际科技合作与交流计划项目(2015KW-047);陕西省社会发展公关计划(2015SF104);国家自然科学基金(81470415;81470411;81270170;81570330;81570231;81570230;81570232);国家十二五科技支撑计划课题(2011BAI11B20);陕西省科技统筹创新工程计划项目(2013KTCL03-01)

摘　　要：目的总结运用主动脉弓滑动成形技术治疗主动脉缩窄合并弓发育不良的临床经验。方法回顾性分析2013年1月至2015年5月间采用主动脉弓滑动成形术治疗主动脉缩窄合并主动脉弓发育不良患儿8例的临床资料。患儿年龄2~21（7±5.4）个月,体重4~10（6.6±1.7）kg,男性6例,女性2例。均经过胸骨正中切口在深低温体外循环下一期完成手术,根据患儿主动脉病理解剖的不同,主动脉弓滑动成形方法略有不同,以达到最好的解剖矫治效果。结果 8例患儿均成功完成手术。全组无死亡,未出现肾功能障碍及神经系统功能并发症。术后定期随访6~20（16±5.6）个月,末次随访患者下肢收缩压均高于上肢收缩压0~15（8.9±3.2）mm Hg,未发现再狭窄发生。结论主动脉弓滑动成形术治疗主动脉缩窄合并弓发育不良具有良好的近远期效果。Objective To summarize our clinical experience of aortic arch sliding aortoplasty in surgical repair of coarctation ofthe aorta and hypoplastic aortic archin infants.Methods Eight patients with coarctation of the aorta and hypoplastic aortic archunder-went surgical repair with aortic arch sliding aortoplasty technique between January 2013 and May 2015 were retrospectively analyzed.The patients＇ age was 2~21（7±5.4）months and weight was 4~10（6.6±1.7）kg, 6 male and 2 female. All operations were performedthrough median stemotomy under deep hypothermia cardiopulmonary bypass with selective cerebral perfusion. According to the patholog-ical anatomy of the aortic arch, the technique was tailored to reach optimal anatomical repair in different patient.Results All opera-tions were performed successfully. There was no mortality or major morbidity such as renal dysfunction or nervous system complications.Follow-up was carried out between 6 and 20（16±5.6）months. At the last follow-up, the lower limb systolic blood pressure were 0~15（8.9±3.2）mmHg higher than upper limb systolic pressure. No patient had residual obstruction.Conclusions Aortic arch sliding aorto-plasty is ansafe and effective surgical method to treat coarctation of the aorta with hypoplastic aortic arch with excellent results.

关 键 词：主动脉缩窄 主动脉弓发育不良 主动脉成形术 

分 类 号：R726.5[医药卫生—儿科]