摘要
目的探讨肺动脉和下腔静脉直接连接的改良Fontan手术对功能性单心室的适用性和安全性，评价手术的早期结果进行评价。方法2005年8月到2012年3月，23例患儿接受肺动脉与下腔静脉直接连接的改良Fontan手术，年龄2～13岁，体质量9～28kg。手术均在体外循环下进行。所有患儿的主肺动脉与肺动脉分支发育良好，无张力下完成肺动脉与下腔静脉吻合。下腔静脉在肺动脉主干同侧8例，对侧7例，其他类型8例。回顾性分析患儿临床资料和手术数据。结果手术死亡1例。22例术后血流动力学稳定。13例需持续胸腔引流。术后复查下腔静脉与肺动脉吻合口均通畅。结论肺动脉与下腔静脉直接连接的Fontan手术治疗功能性单心室可行，即保留了心外管道连接术的优点，又避免使用人工材料。
Objective In order to optimize the Fontan circulation, a technique for direct total cavopulmonary connection was devised. To evaluate its surgical feasibility as well as surgical outcomes, our clinical experience was retrospectively reviewed. Methods From August 2005 to March 2012, 23 consecutive patients underwent modified extracardiac Fontan operation with direct total eavopulmonary connection. Clinical profile of the patients, and procedural variables were examined and analyzed. Results All patients had adequately developed main and branch pulmonary arteries. Inferior caval vein was contralateral to the pulmonary trunk main pulmonary artery in 7 cases, ipsilateral in 8, and others in 8. There was 1 hospital death. The other 22 patients remained hemodynamieally stable postoperatively. Prolonged effusions （n = 13,62% ） was a challenging problem. No obvious stenosis was found at the direct eavopulmonary anastomosis. Conclusion we are convinced that a direct total cavopulmonary connection is feasible in select subset of patients. This modified Fontan procedure retains the advantage of extracardiae connections together with the avoidance of prosthetic materials.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2014年第2期65-67,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
基金
“十二五”国家科技支撑计划课题资助（2011BAI11B22）
关键词
心脏缺损
先天性
FONTAN手术
全腔肺动脉连接术
单心室
Heartdefeets, congenital Modified Fontan procedure Total eavopulmonary connection Single ventricle
