河北医学2011，Vol.17Issue(4)：448-450,3.DOI:10.3969/j.issn.1006-6233.2011.04.010
大动脉调转术在小儿复杂先天性心脏病中临床应用
Arterial Switch Operation for Pediatric Clinical Application of Complex Congenital Heart Diseases
钟志敏 1胡楝 1钟焕清 1谢翠贤 1刘超 1余观水1
作者信息
- 1. 广东省高州市人民医院心外科,广东,高州,525200
- 折叠
摘要
Abstract
Objective: To summarize the complicated clinical experience of the treatment of arterial switch operation in children with congenital heart disease. Method: 32 patients,aged 12 days to 3 years,with the mean body weight of 2.9 -15 kg, underwent arterial switch operation. Among the 32 patients 12 suffered from TGA with intact ventricular septum , 18 from TGA with ventricalar septal defect ( VSD ）, 2 from Taussing-Bing anomaly; 15 were complicated by atrial septal defect( ASD ） and all complicated by patent ductus arteriosus (PDA ） ;23 had severe pulmonary hypertension; Coronary type A distribution was recognized in 30 cases,type D in 2 cases. The operation was performed under general anesthesia and extracorporeal circulation with low temperature and low volume blood flow. The aorta and pulmonary artery were transected above the valvular commisures. The coronary ostia with all the adjacent sinus of valsalva were exercised and reimplanted to the proximal neoaorta, and then aortic anastomosis was completed. The proximal neo -pulmonary trunk was reconstructed with a large autologous native pericardiun as aposterior patch. The pulmonary anastomosis was completed after the aortic cross clamp was released. The VSD was repaired through the atrium or proximal aorta with dacron patches. Result: 4 patients died with a hospital mortality rate of 12.5％ . Children with preoperative pulmonary hypertension, pulmonary arterial pressure was significantly decreased after surgery. The remaining 28 patients had recovered well and discharged. Follow-up of 1 to 24 months showed survival with no complications and death. Conclusion: Arterial switch operation has achieved good short and long term efficacy, the treatment of TGA and Tausing-Bing malformation of the preferred surgical method.关键词
完全型大动脉转位/心脏病/大动脉调转Key words
Complete type transposition of great arteries/ Heart disease/ Arterial switch引用本文复制引用
钟志敏,胡楝,钟焕清,谢翠贤,刘超,余观水..大动脉调转术在小儿复杂先天性心脏病中临床应用[J].河北医学,2011,17(4):448-450,3.
