摘要
本文报告体外循环下闭合动脉导管179例。在深低温低流量体外循环下,经肺动脉切口闭合动脉导管142例;常温体外循环下结扎动脉导管6例;体外循环下阻断动脉导管经肺动脉切口缝合动脉导管内口5例;左胸后外侧切口常温体外循环并行下行切断缝合26例。近期死亡5例(2.8%),远期效果良好。作者就手术适应证、基本方法、手术方式的选择及术后并发症进行讨论。
From January 1982 to December 1990, 179 cases of PDA were operated under CPB in Fu Wai Hospital. Using median sternotomy, 147 cases of PDA were closed through the transpulmonary route using deep hypothermia with low flow rate; 4cases were ligated within the pericardial cavity; 2 cases were ligated outside and then directly sutured the pulmonary orifice through the transpulmonary router 26 cases were divided and sutured under posteriolateral in(?)sion without aortic cross clamping. There were 5 cases of operative death (mortality rate 2.8%) and 1 late death. The indication for closure of PDA under CPB are (1) large ductus associated with severe pulmonary hypertension or the patient is more than 15 years old, (2) recurrent, calcified or infected ductus, (3) associated with other intracardiac anomalies, (4) abnormal position of PDA, (5) associated with systemic hypertension, (6) PDA plug entering the pulmonary artery, (7) window type ductus. We recommend closure of PDA through the transpulmonary route as it is safer than others. The technique of the method was described in detail. Risk factors of the method, postoperative complications and their prevention were also discussed.
出处
《中国循环杂志》
CSCD
1992年第2期159-161,共3页
Chinese Circulation Journal
关键词
动脉导管未闭
体外循环
手术
Patent ductus arteriosus (PDA)
Cardiopulmonary bypass (CPB)
