全肺静脉异位引流18例外科治疗体会

Surgical treatment for total anomalous pulmonary venous drainage: report of 18 cases

摘要: 目的:总结全肺静脉异位引流(total anomalous pulmonary venous drainage,TAPVD)治疗的经验。方法:在全身麻醉、低温、体外循环下对18例TAPVD患儿行矫治手术,其中8例心上型采用左心房顶部入路。结果:痊愈15例,术后早期病死3例,病死率为16.7%。延迟关胸2例。心律失常4例,均经治疗痊愈。痊愈患儿随访4~48个月,心功能正常。结论:TAPVD手术治疗成功的关键在于左心房与肺总静脉吻合口应足够大,避免狭窄的发生。

Abstract: Objective: To summarize the experience in treatment of total anomalous pulmonary venous drainage(TAPVD).Methods: Eighteen cases received surgical correction of TAPVD under hypothermia and cardiopulmonary bypass.Eight supracardiac patients were operated on through the top approach of left atrium.Results: Fiteen patients survived.Early mortality occurred in 3 cases(16.7%),delayed wound closure after surgery in 2 cases and arrhythmia in 4 cases.All of them recovered uneventfully.The cardiac function returned to normal in all the 15 cases during the follow-up term of 4 to 48 months.Conclusions: The key to successful operation lies on enough anastomotic orifice and avoidance of anastomotic stenosis.