心上法矫治小儿完全性心上型肺静脉畸形引流(附11例报告)  

The superior approach for correction of the supracardiac type of total anomalous pulmonary venous connection

作　　者：刘迎龙[1] 于存涛[1] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院外科,100037

出　　处：《中华胸心血管外科杂志》2003年第6期321-323,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的　介绍心上法矫治心上型完全性肺静脉畸形引流 (TAPVR)。方法　 1998年 6月至2 0 0 1年 8月 ,采用心上法矫治心上型TAPVR 11例 ,其中男 7例 ,女 4例 ;年龄 5月龄～ 15岁 ,平均 (5 33±4 98)岁 ;体重 6 4～ 33 0kg ,平均 (15 0 9± 8 78)kg。在全麻、低温体外循环下行矫治术 ,正中切口纵劈胸骨入胸 ,经横窦 ,上腔静脉与升主动脉之间显露共同肺静脉干及左心房 ,将其侧侧吻合。结果　术后早期 (30d)无死亡 ,随访 4～ 36个月 ,无远期死亡及心律失常发生。结论　心上法矫治心上型TAPVR可获得良好的显露和足够大的吻合口 ,手术对心脏的损伤小 ,可降低术后心律失常的发生率。Objective: To describe the superior approach for correction of supracardiac (type I) total anomalous pulmonary venous return. Methods: From June 1998 to August 2001, total 11 of the supracardiac type of TAPVC were corrected by the superior approach. There were 7 males and 4 females with mean age of (5。33±4。98) years(5 months to 15 years) and mean weight of (15。09± 8。78)kg (6。4 to 33 kg). The total correction was performed under CPB. The top of the left atrium and the common pulmonary venous trunk were exposed through the transverse sinus and a direct anastomosis between those was done. Results: There was no operative mortality. No late death and arrhythmia occurred during follow-up period (4 months to 3 years). Conclusion: This superior approach for correction supracardiac type of TAPVC can afford a better exposure and a bigger orifice between the left atrium and the common pulmonary venous trunk and less injury. Therefore, the postoperative morbidity of arrhythmia is low.

关 键 词：心上法 小儿 完全性心上型肺静脉畸形引流 体外循环 心律失常 矫治 

分 类 号：R726.5[医药卫生—儿科]