摘要
目的探讨经胸骨正中切口一期矫治小儿主动脉缩窄(CoA)及合并畸形的手术方法和治疗效果。方法2002年6月至2005年8月手术治疗CoA及合并畸形36例,其中男27例,女9例;年龄18d^8岁,平均(14·3±9·5)个月,其中小于1岁27例,小于3月龄18例;体重3~23kg,平均(6·6±3·0)kg。有症状的婴儿型27例,无症状的大儿童型8例,经左胸切口矫治CoA后再狭窄1例;合并室间隔缺损、动脉导管未闭、房间隔缺损、主动脉弓发育不良、完全性大动脉转位及主动脉瓣下狭窄等心内畸形。36例均经胸骨正中切口以扩展端端吻合术一期矫治CoA及合并畸形。结果手术死亡1例,系术前反复心力衰竭及充血性肺炎,术后15d死于心肺功能衰竭。35例随访4~36个月,晚期死亡1例。生存34例恢复良好,无再缩窄发生。结论经胸骨正中切口一期矫治CoA及合并畸形效果良好;扩展端端吻合法是一种值得推荐的技术。
Objective To evaluate the outcomes of one-stage repair of aortic coarctation （CoA） and associated cardiac anomalies in infants through a midline stemotomy. Methods Between June 2002 and August 2005, 36 patients （27male, 9 female） underwent surgery for CoA. The age was from 18 days to 8 years [ mean （ 14. 3 ± 9.5） months ], 27 patients （75 % ） were younger than 1 year and 18 patients （50%） were younger than 3 months. The body weight was from 3.0 to 23 kg [ mean（6.6 ± 3.0）kg]. 27 patients were symptomatic infants and 8 patients were asymptomatic of adults. One patient had recoarctation after repair through a left thracotomy one year ago. The associated cardiac anomalies included ventricular septal defect, patent duetus arteriosus, secundum atrial septal defect, hypoplasia of the aortic arch, transposition of great arteries and subaortic stenosis. 36 cases underwent one-stage operation of extended end-to-end anastomosis through a midline stemotomy, Results One patient died postoperatively with a mortality of 2.8 %. The cause of death was heart and lung function failure. 35 cases were followed up flora 4 months to 3 years . One late death occurred. 34 cases were in good condition and no reeoaretation. Conclusion Outcomes of one-stage repair of CoA and associated cardiac anomalies in infants through a midline stemotomy is excellent. Technique of extended end -to-end anastomosis may potentially reduce the incidence of recoarctation.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2006年第6期374-376,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
主动脉缩窄
心脏缺损
先天性
心脏外科手术
Aortic coarctation Heart defects, congenital Cardiac surgical procedures
