摘要
目的探讨法洛四联症(TOF)合并不同类型的主肺侧支动脉(MAPCA)行手术矫治的适应证、方法及效果.方法 2000年1月至-2004年5月对9例TOF合并MAPCA患者行矫治手术治疗,其中5例合并肺动脉闭锁,男性6例、女性3例,年龄3～9岁.手术均在中度低温体外循环下进行,5例先采用介入技术弹簧圈封堵MAPCA,随即行心内矫治手术,采用涤纶补片修复室间隔缺损, 右心室流出道重建;1例心内矫治手术中结扎MAPCA;3例合并Ⅲ或Ⅳ型肺动脉闭锁患者采用一期单源化手术,2例心内修复术,1例室间隔缺损开放.结果术后早期死亡1例,死亡原因为脊髓内出血. 随访3个月～4年,NYHA心功能Ⅰ、Ⅱ级7例,Ⅲ级1例.结论合并MAPCA的TOF患者一经诊断应尽快手术,结合介入技术方法,早期行矫治手术可以得到满意的效果.
Objective To evaluate the indication and operative program of complete repair of tetralogy of Fallot with major aortopulmonary collateral arteries （TOF-MAPCA）. Methods From Janunary 2000 to May 2004, 9 patients with TOF-MAPCA including 5 patients with pulmonary atresia underwent complete surgical repair , 6 of them were male and 3 were female. The ages ranged from 3 to 9 years. All patients underwent corrected operations with moderate hypothermia and cardiopulmonary bypass. Transcatheter occlusion of MAPCA was performed in 5 patients just before corrected operation. Ligation of MAPCA was performed in 1 patient in the same time of cardiac corrected operation. Midline one-stage complete unifocalization and repair were performed in 3 patients with pulmonary atresia. Results There was one early death. The cause of death was spinal cord hemorrhage. There was no death then . Eight patients were followed up from 3 month to 4 years. Heart function （NYHA） was class Ⅰ or Ⅱ in 7 patients and Ⅲ in 1 patient. Conclusions Completely surgical repair of patients with TOF-MAPCA should be performed as early as possible, which can achieve with satisfactory results by transcatheter occlusion of MAPCA or one-stage unifocalization.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2005年第22期1437-1440,共4页
Chinese Journal of Surgery
关键词
法乐氏四联症
心血管畸形
心脏外科手术
Tetralogy of Fallot
Cardiovascular abnormalities
Cardiac surgical procedures
