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	动脉调转术治疗心室大动脉连接异常的先天性心脏病
其他题名	Clinical use of arterial switch operation for the complex congenital heart defects with ventriculoarterial connection anomaly
	刘迎龙; 胡盛寿; 沈向东; 李守军; 王旭; 闫军; 冯滨; 崔彬
来源期刊	中华胸心血管外科杂志
ISSN	1001-4497
出版年	2005
卷号	21 期号:4 页码:207-209
中文摘要	目的总结动脉调转术(ASO)治疗心室大动脉连接异常的先天性心脏病(先心病)手术疗效.方法 2000年1月至2004年8月,60例病儿实施ASO,早年(2000.1～2003.5)42例,近期(2003.6～2004.8)18例;其中完全性大动脉转位(TGA)49例、Taussig-Bing畸形7例、矫正性大动脉转位(ccTGA)4例;年龄1～6个月15例、7～12个月14例、1～3岁6例、＞3岁6例,其中＞6月龄的TGA/VSD或TGA/PDA 18例.行大动脉调转术,同期矫治合并畸形;ccTGA病儿先行心房转流术,后行ASO.结果全组手术死亡10例(16.7%),其中早年9例(21.4%)、近期1例(5.6%),死亡率明显下降(P＜0.05).生存病儿随访0.5～56.0个月,心功能恢复良好,无死亡及并发症.结论 ASO应用于TGA、Taussig-Bing畸形以及ccTGA能取得良好的手术结果.针对国内TGA/VSD或TGA/PDA病儿就诊较晚、年龄较大,肺动脉压力较高等特点,如心导管检查显示肺小动脉阻力不高,ASO仍可获得满意的疗效.
英文摘要	Objective To sunmiariy.es ihe olinkuil i*xpi;ritMn:e of tli<" urleriiil swilch opemtiun ( ASO) fur the complex amgrniiial heart dnfecta wilh vontriuuluarleriiil connection anomaly. Methwls lictwwm JiuuiaiT 2(XX0 und Au^st 2(X)4, 60 consecutive nnmulul iuul infunts, iigcd 2 days to 11 years wilh mean body weight (6.5 4.3)kg (2.6 - 22 kg) , underwent the arterial switch operation at Fu Wui hospittil, including42 patients in early years (2(XX). 1 ~ 2003.5), mid eighteen pulienLs in recenl yeiys (2003.6- 2004.8). Primary cardiac diagnoses included transposition of the gieul arteries (TGA, n = 49) and Tuussing-Bing anomaly (TBA , n = 7). and the oongenitally corrected transposilion of Ihe great arteries ((!(;TGA, n = 4). The operation was performed under general anesthesia and exlracorporeal circulation with the low temperature and low volume blood flow. The great arteries were trurisedral aliove the valvu-lar commissures; the coronary ostin wilh all the tidjaeenl sinus of vulsalva were excised and reimplanled to the proximal neo-aorta. The proximal neo-pulinonmy Imnk wu.s rccunstmt^tral with a large autologous native pericardium as a ptuitatoon patch. rl"he pulmonary anas-tomosis was completed after the aortic cross-i:lanip was released. The VSDs were repaired through llie oliium or proximal nortii with du-cron patches. For ihe patients with ccTGA, double switch operation included Senning procedure and ASO wer? perfonned. Results The total operative mortality rale was 16.7% (10 cases), 9 oases in early yeara (21 .4% , 9/42) and 1 case in recent year (5.6% , 1/18), two groups had significant difference (P < 0.05 ) . The pulmonary pressure was reduced significantly in oil patients after ASO. 50 patients were discharged from hospital uneventfully. l’ollowa-up [0.5 to 56 months, (13.5 7.9) months] showed survivurs hav-ing no complications and death, cyanosis was significantly reduced, and physical activities increased obviously. Conclusion ASO re-mains the procedure of choice for the treatment of various forms of TGA, TBA or ccTGA with acceptable early and later outcome in lenns of overall survival rate and freedom from reoperation. For older patients and with pulmonary hypertension, or with left ventricular outflow tract (LVOT) obstruction if calhctcrmition shows low pulmonary sirterioles resistance, ASO may still end in satisfactory results.
中文关键词	大血管错位/外科学 ; 右室双出口/外科学
英文关键词	Transposition of great vessels/surgery Double outlet righl ventricle/surgery
语种	中文
国家	中国
收录类别	CSCD
WOS类目	SURGERY
WOS研究方向	Surgery
CSCD记录号	CSCD:2012465
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/207087
作者单位	中国医学科学院中国协和医科大学阜外心血管病医院心血管病研究所外科, 北京 100037, 中国
推荐引用方式 GB/T 7714	刘迎龙,胡盛寿,沈向东,等. 动脉调转术治疗心室大动脉连接异常的先天性心脏病[J],2005,21(4):207-209.
APA	刘迎龙.,胡盛寿.,沈向东.,李守军.,王旭.,...&崔彬.(2005).动脉调转术治疗心室大动脉连接异常的先天性心脏病.中华胸心血管外科杂志,21(4),207-209.
MLA	刘迎龙,et al."动脉调转术治疗心室大动脉连接异常的先天性心脏病".中华胸心血管外科杂志 21.4(2005):207-209.