摘要
目的评估Hybrid手术治疗成人法洛四联症(TOF)合并体肺侧支(APCAs)封堵时机及临床效果。方法回顾性分析我院16例成人TOF合并APCAs患者,10例患者于TOF根治术前行介入封堵APCAs,6例术后封堵APCAs。所有患者均在低温体外循环下行常规TOF根治术。心血管造影诊断APCAs血管41支。术前介入栓堵22支,术后介入栓堵的APCAs 9支。结果 10例在术前心血管造影,提示APCAs≤4 mm,先行介入封堵治疗,31支侧支有22支成功封堵且无并发症,再入手术室行TOF根治术。6例患者AP-CAs>4 mm,行TOF根治术后出现心衰,施行封堵治疗,10支侧支有9支成功封堵且无并发症。结论对于非单独供血肺组织的APCAs≤4 mm,术前进行介入封堵,>4 mm术后施行介入封堵,可降低手术难度,减轻手术创伤,提高手术矫治成功率。
Objective To evaluate the occasion of combined collateral embolization and clinical outcomes of Hybrid surgery for adult tetralogy of Fallot（TOF） with major aorto pulmonary collateral arteries（MAPCAs）.Methods we reviewed retrospectively the clinical data of 16 adult patients suffered TOF＇s with MAPCAs,which underwent peroperative embolization of MAPCAs.Preoperative and postoperative interventional embolization was adopted in 10 and 6 patients,respectively.Results All 16 patients underwent combined therapy of MAPCAs occlusion and complete repaired.Angiography was performed before surgery.Ten out of the sixteen patients underwent transcatheter embolization if the diameter of collateral vessels ≤4 mm before surgical repaired.Tweenty two collateral vessels were occluded successfully with 31 coils without any complication.Embolization was performed after corrective surgery in 6 patient with postoperative congestive heart failure of which the diameter of collateral vessels 4 mm.Conclusion For patients with dual pulmonary blood supply from MAPCAs and native pulmonary arteries,patients underwent transcatheter embolization if the diameter of collateral vessels ≤4 mm before surgical repair,while the diameter of collateral vessels 4 mm after TOF radical operation.Hybrid surgery can simplify the operation procedures,shorten operation time and alleviate injury.
出处
《安徽医科大学学报》
CAS
北大核心
2011年第9期938-940,共3页
Acta Universitatis Medicinalis Anhui
基金
安徽省卫生厅医学科研课题项目(编号:2010C60)
