体外循环心脏不停跳下心外管道Fontan手术  

Fontan operation with extracardiac conduit on beating hearts

作　　者：汪钢[1] 王伟宪[1] 蔡振杰[1] 易定华[1] 俞世强[1] 刘建平[1] 张近宝[1] 刘维永[1] 陈文生[1] 郑奇军[1] 

机构地区：[1]第四军医大学西京医院心血管外科,西安710032

出　　处：《中华外科杂志》2004年第8期458-461,共4页Chinese Journal of Surgery

摘　　要：目的　评估体外循环心脏不停跳下心外管道Fontan手术的方法及其效果。　方法　本组 4 2例中 ,男性 31例、女性 11例 ,年龄 3～ 19岁 ,其中心室双入口 19例 ,三尖瓣闭锁 10例 ,二尖瓣闭锁 3例 ,其他复杂先天性心脏病 10例。均在常温体外循环心脏不停跳下施行心外管道Fontan手术 ,其中 8例加行开窗术 ;1例先做了双向腔肺动脉分流术 ,术后 2年行心外管道Fontan手术。结果　术后早期和晚期各死亡 1例 ,分别死于急性肝功能衰竭和反复肺部感染 ,随访 1 0～ 4 5年 ,4 0例心功能为Ⅰ级和Ⅱ级 ,动脉血氧饱合度 92 %～ 96 %。　结论　体外循环心脏不停跳下心外管道Fontan手术的近、中期效果满意 ,可在单一心室修复中选用。Objective To evaluate the results of Fontan operation with extracardiac conduit on beating hearts. Methods Forty-two patients (31 males and 11 females) age ranged from 3 to 19 years old included in this study. There were 19 double inlet-ventricle, 10 tricuspid atresia, and 3 patients with mitral atresia, 10 patients with other complex congenital cardiac malformations. Fontan operations with extracardiac conduit were performed in all patients with the help of cardiopulmonary bypass without hypothermia in this study. Atrial septal fenestration was performed in 8 patients.In one patient, bi-directional cavopulmonary procedure was performed 2 years before Fontan operation. Results There was one early death caused by acute hepatic function failure and one late death caused by repeated lung infections. The follow-up of 1 to 4.5 years showed that all patients′ cardiac functions were grade Ⅰ to Ⅱ, and arterial oxygen saturation was 92%～96%. Conclusions The early and mid-term outcome of Fontan operation with extracardiac conduit on beating hearts is good and the method can be used in the single ventricle repair.

关 键 词：体外循环 心脏不停跳 心外管道 FONTAN手术 

分 类 号：R654.1[医药卫生—外科学]