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矫正型大动脉转位合并心内畸形的外科治疗

Surgical Treatment of Congenital Anomalies Associated with Corrected Transposition of Great Arteries

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【作者】 何忠良何晓雯陈如坤程海峰张昌铭

【Author】 Department of Thoracic and Cardiovascular Surgey, Second Affiliated Hospital ofMedical School of Zhejiang University, Hangzhou(310009)He Zhongliang, He Xiaowen, Chen Rukun, et al.

【机构】 浙江大学医学院附属第二医院心胸外科浙江大学医学院附属第二医院心胸外科 杭州 310009杭州 310009杭州 310009

【摘要】 目的:为探讨矫正型大动脉转位的病理解剖特点及手术技术。方法:本组6例均为SLL型,手术包括:室间隔缺损修补4例、肺动脉瓣切开1例、静脉室肺动脉外通道1例、左房室瓣替换1例。结果:全组手术死亡1例。主要手术并发症为低心排4例、完全性房室传导阻滞1例及残余左房室瓣关闭不全1例。结论:矫正型大动脉转位的病理解剖有一定的特殊性,应按不同的合并畸型选择不同术式,正确处理室间隔缺损、肺动脉流出道狭窄及左房室瓣关闭不全是外科手术的关键。

【Abstract】 Objective The aim of this study was to evaluate the pathological features and experience of surgical treatment of this disease. Surgical repair of six patients with congenital anomalies associated with corrected transpositon of great arteries (CTGA) was reviewed. Methods: They included 4 males and 2 females. The mean age was 16. 5 years (range, 10 to 30 years). The associated anomalies included ventricular sepeal defect (VSD) in 4 cases, pulmonary outflow tract obstruction (POTO) in 2, and left atri-oventricular valve incompetence in 1. Surgical procedures were repair of VSD in 4 patients, pulmonary valvotomy in 1, extracardiac valved conduit in 1 and replacment of LAVI in 1. Results : There was one peri-operative death resulting from severe low cardiac output. The main postoperative complications were Ⅲ° a-trioventricular block in 1 patient, residual LAVI in 1, and low cardiac output in 4. Conclusion:The results of this study demenstrated that it is very important to choose appropriate surgical procedure for diffirent anomalies with CTGA. Complete correction of this anomalies is closely related to the surgical outcome of this disease.

  • 【文献出处】 上海生物医学工程 ,Shanghai Journal of Biomedical Engineering , 编辑部邮箱 ,2001年02期
  • 【分类号】R654.2
  • 【下载频次】41
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