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小儿永存动脉干9例外科诊治
Surgical correction of 9 children with persistent trucus arteriosus
【摘要】 目的:总结9例小儿永存动脉干(PTA)外科治疗的经验。方法:1994年4月至2004年3月外科手术纠治9例PTA。年龄18个月~6岁,体重6.5~18kg。按VanPraagh分型,A1型5例,A2型2例,A3及A4型各1例。右心室肺动脉流出道重建,均用同种带瓣主动脉。结果:PTA发病率0.36%,死亡率11.1%(19)。早期死亡l例,早期并发肺部感染1例,术后随访6例,1例残余室间隔缺损(VSD),1例残余右心室流出道梗阻,2例主动脉瓣轻度关闭不全,1例主动脉瓣中度关闭不全。结论:PTA易早期并发肺血管梗阻性疾病,应尽早纠治。手术要点是防止VSD残余分流;分离肺动脉和修复动脉干缺损时,应避免损伤动脉干瓣膜及冠状动脉口。
【Abstract】 Objective:To review the expericnce of surgical correction of persistent truncus arteriosus(PTA)Method:From April.1994 to March 2004,nine children with PTA,aged 18 months-6 years,weighed 6 ^5-18 kg,underwent surgical correction.There were 5 cases with type A1,2 type A2, each 1 type A3 and A4 according to Van Praagh’s classification.In reconstruction of right ventricle to pulmonary outflow tract,aortic homograft were used in all cases.Result:PTA is rare among cardiovascular diseaes (0 ^36%).The operative mortality rate was 11 ^9% (1/9).Early death occurred in one case.Early pulmonary infection in 1.6cases were followed up in 1-6a.residual shunt in 1,residual right ventricular outflow tract stenosis in 1,lighter arotic regurgitation in 2,middle arotic regurgitation in 1.Conclusion:PTA is apt to develop pulmonary vascular obstructive disease early and correction should be done before one year.Surgical main points:Residual VSD has to be avoided;Careful attention to the truncal value and coronary ostia is critical when the pulmonary artery is dissected and the truncal defect is repaired.
【Key words】 Heart defects congenital Persistent truncus arteriosus Heart surgery procedures;
- 【文献出处】 心肺血管病杂志 ,Journal of Cardiovascular and Pulmonary Diseases , 编辑部邮箱 ,2005年03期
- 【分类号】R726.5
- 【被引频次】1
- 【下载频次】60