摘要
目的 观察复杂心脏畸形右室双出口外科治疗效果 .方法 1991- 12 /1997- 0 5我院对 2 3例 (男 17,女 6 )右室双出口患者进行根治手术 ,年龄 4mo～ 16岁 ( 6 .8± 3.6 )岁 .病理解剖均为两大动脉起于右心室 ,主动脉瓣和二尖瓣无纤维连续性 .其中 SDD型 18例 ,SDL 型 3例 ,IL L 型 1例 ,IDD型 1例 ,室缺位于主动脉下 12例 ,肺动脉下 3例 ,其中 Taussig- Bing畸形 2例 ,靠近两大动脉开口 5例 ,远离两大动脉开口 3例 .有肺动脉狭窄 18例 ,无肺动脉狭窄伴肺动脉高压 5例 ,合并房缺 15例 ,动脉导管未闭 4例 ,左上腔静脉畸形 5例 ,右室流出道横跨粗大冠状动脉 5例 ,合并肺动脉内折断之右心导管异物 1例 .结果 手术阻断升主动脉时间为 46 .8～ 12 0 .3 ( 72 .4± 18.5 )min,体外循环时间为 71～ 184.7( 12 0 .2± 2 7.6 ) min.术中应用心内隧道 16例 ,心内管道 7例建立室缺肺动脉口连续性 ,应用带瓣管道 5例 ,带单瓣补片 7例 ,单纯补片 11例加宽右室流出道 .对 Taussig- Bing畸形应用改良 Patrick- Mc Goon心室内调转手术 .全组手术死亡 2例 ,死亡率为 8.7% ,心功能均恢复到I级 .
AIM To observe the result of surgical treatmentfor double outlet of right ventricle (DORV). METHODS Twentythree cases of DORV underwent heart surgery correctly from Dec. of 1991 to May of 1997. There were 17 males and 6 females at the age of 4 mo^16 yr (6.8±3.6) yr, pathologic anatomy showed that both great vessels arose from the right ventricle and that no aortictomitral fibrous continuity was found in all cases. There were 18 cases of type SDD, 3 SDL, 1 ILL AND 1 IDD, with 12 cases of subaortic VSD, 3 subpulmonay VSD including 2 TaussingBing deformity, 5 doubly committed VSD and 3 noncommitted VSD. There were 18 cases of pulmonary stenosis and 5 pulmonary hypertention. The associate deformations included 15 ASD, 4 PDA, 5 LSVC, 5 left coranary artery passing anterior to pulmonary outflow, and 1 foreign material in pulmonary artery. RESULTS The circulation clamp time was 46.8~120.3 (72.4±18.5) min. The extrocorpereal circulation time was 71~184.7 (120.2±27.6) min. One case of TaussigBing deformity underwent modified intraventricular switch operation. The operative mortality was 8.7%(2/23). CONCLUSION The good operative result can be obtained from surgical treatment of DORV.
出处
《第四军医大学学报》
2000年第5期571-573,共3页
Journal of the Fourth Military Medical University
