摘要
目的:回顾分析主肺动脉窗及合并心脏畸形的临床特征,总结外科手术治疗的经验和效果。方法:自1997-01至2011-05,共有46例主肺动脉窗患者接受了外科手术治疗,平均年龄(3.2±2.5)岁(0.1～16)岁,平均体重(11.4±6.2)kg(4～47)kg。合并的心脏畸形包括右肺动脉起自升主动脉7例、二尖瓣关闭不全7例、主动脉瓣下隔膜5例、动脉导管未闭6例、主动脉弓中断5例、室间隔缺损4例、房间隔缺损4例、右室双出口3例、三尖瓣关闭不全2例、右冠状动脉起自肺动脉2例、法乐四联症1例。43例患者在体外循环下手术,其中23例经主动脉切口补片修补,12例经肺动脉切口修补,4例经主肺动脉窗修补,2例行切断缝合。其余3例患者在非体外循环下行主肺动脉窗缝扎(1例)或切断缝合(2例)。合并心脏畸形同时矫治。结果:早期死亡3例,平均随访5年,1例患者术后一年死于肺动脉高压,其余患者无再次手术及残余分流,主动脉和肺动脉发育正常。结论:主肺动脉窗一经诊断,应尽早外科手术治疗,体外循环下经主动脉切口补片修补是首选的方法。
Objective： To summarize the clinical features and outcomes in patients of surgically corrected aortopulmonary window（APW）with the associated lesions. Methods： We retrospectively summarized 46 patients who were surgically treated for their APW in our hospital from 1997 to 2011.The patients mean age was（3.2±2.5）years,the body weight at（4 ~47）kg,with the mean weight of（11.4±6.2）kg.The associated cardiac anomaly included aortic origin of the right pulmonary artery in 7 cases,mitral insufficient in 7 cases,sub aortic stenosis in 5 cases,patent ductus arterious in 6 cases,interrupted aortic arch in 5 cases,ventricular septal defect in 4 cases,atrial septal defect in 4 cases,double outlet right ventricle in 3 cases,tricuspid insufficient in 2 cases,anomalous origin of right coronary artery from pulmonary artery in 2 cases,and tetralogy of Fallot in 1 case. Results： 43 patients received surgical repair under cardiopulmonary bypass（CPB）.23 of them had transaortic patch closure,12 had transpulmonary repair,4 with patch repaired through opened APW,2 patients had APW divided and over sewn.The other 3 patients received surgical repair without CPB.1 of them had APW ligated,2 had APW divided and over sewn.The associated cardiac anomaly was corrected at the same time.The patients were followed-up at the mean time of 5 years.There were 3 early deaths.1 patient died of pulmonary hypertension 1 year after the operation.All the other survivors had no residual shunt,no re-operation,the aorta and pulmonary artery had normal growth. Conclusion： APW should be surgically corrected as early as it is diagnosed,trans aortic patch repair with CPB is the primary choice.
出处
《中国循环杂志》
CSCD
北大核心
2012年第2期126-129,共4页
Chinese Circulation Journal
