摘要
目的 应用自行采集和冷冻保存的同种带瓣大动脉 (VHC)完成先天性心脏病右心室流出道的重建 ,并观察其疗效及存在的问题。 方法 用 VHC材料治疗先天性心脏病 95例 ,90例手术根治 ,5例行 VHC右心室流出道与肺动脉连接姑息手术。 结果 院内死亡 13例 ;术后随访 6 8例 ,死亡 2例 ,均为感染。 6 6例长期生存者中 2 5例胸部 X线片示 VHC有钙化 ,多为主动脉材料 ,仅 5例有轻中度压力阶差 (35～ 6 0 mm Hg)。 结论 VHC可广泛用于治疗复杂先天性心脏病。程序降温、超低温保存和两步化冻是 VHC使用质量的保证。 VHC的长期通畅比合成管道好 ,随植入时间延长钙化率增加 ,肺动脉 VHC优于主动脉。有肺动脉高压者宜尽早手术。为了预防 VHC植入后感染 ,应重视、改进其收集和保存的方法。
Objective To reconstruct the right ventricular outflow tract using cryopreserved valved homograft conduit(VHC) and to review the curative effects and remaining problems. Methods Ninety-five patients with complex congenital heart disease were treated from Nov.1989 to Feb.2000.The diagnosis included: transposition of the great artery, double outlet right ventricle, tetralogy of Fallot, persistent truncus arteriosus and aortic stenosis. The corrective operations were performed in 90 cases, and palliative operations in 5 cases. Results The hospital mortality was 13.7%, and 68 cases were followed up from 1 month to 8 years postoperatively with 25 cases showed calcification in VHC by chest X-ray, but only 5 cases had mild to moderate pressure gradient across the conduit. Conclusion VHC can be used to treat almost all kind of congenital heart diseases; aortic VHCs are liable to calcificate than pulmonic VHCs; to keep the VHC in good condition, programed cooling, cryopreserving and two-stage melting were important and should always be concerned with VHC infection.
出处
《中国胸心血管外科临床杂志》
CAS
2001年第2期73-81,共9页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
先天性心脏病
同种带瓣管道
超低温保存
姑息手术
根治手术
Congenital heart disease
Valved homograft conduit
Cryopreserve
Palliative operation
Corrective operation
