12例一侧肺动脉起源异常的外科治疗

Surgical repair of aortic origin of the right or left pulmonary artery in 12 cases

目的 总结一侧肺动脉起源异常的术前诊断和手术治疗效果和经验。 方法 回顾分析 1 992年 5月至 2 0 0 2年 1 1月间 1 2例手术治疗的一侧肺动脉起源异常患者。男 1 1例 ,女 1例 ,手术年龄为 9个月～ 1 9岁 ,平均6 0 3岁± 6 2岁。右肺动脉起源异常 9例 ,左肺动脉起源异常 3例 ,起源部位包括升主动脉、主动脉弓、右无名动脉和左侧动脉导管末闭 (PDA)。 1 1例合并有其他心脏畸形。 结果 无手术及住院死亡 ,术前超声心动图检查漏诊3例 ,8例经造影、1例经超高速CT确诊。术式包括异常肺动脉与主肺动脉直接吻合 5例 ,采用同种血管 5例及人工血管 2例。 结论 该病术前超声心动图检查易于漏诊 ,手术治疗效果良好。

Objective To review the experience of diagnosis and surgical repair of aortic origin of the right or left pulmonary artery Methods Twelve patients underwent surgical correction for aortic origin of the right or left pulmonary artery at Fu Wai Hospital between May 1992 and November 2002 There were 11 male(92%)and 1 female(8%)ranging in age from 9months to 19(6 03±6 2)years Of the 12 patients,9(75%)had anomalous origin of the right pulmonary artery(RPA)and 3(25%)of the left pulmonary artery(LPA) The anomalous origin of the right or left pulmonary artery was from the ascending aorta,aortic arch,innominate artery or PDA respectively Eleven patients were associated with other cardiac defects Results There was no fatal cases aftes operation os the pasiod of hospital isatcon Three patients were misdiagnosed by echocardiography preoperatively Anatomic correction of anomalous origin of the RPA or LPA from the aorta included direct anastomosis(5 cases),interposition of a homograft(5 cases)or a prosthetic graft(2 cases) Conclusion Good surgical outcome of aortic origin of the right or left pulmonary artery can be achieved by direct anastomosis or interposition of a graft,but the ease is easy to be inissed diagnosis by echocasdiography