非体外循环下双向格林术19例

Nineteen cases of off-pump bi-directional Glenn shunt

目的 :总结常温非体外循环下双向格林分流术 (Glenn术 )治疗复杂先天性心脏病的体会。方法 :1999年 7月至 2 0 0 3年8月 ,对复杂性先天性心脏病患者 19例行双向Glenn术。其中 17例建立上腔静脉 -右心房旁路行单侧双向Glenn术 ,2例利用双上腔静脉互为旁路行双侧双向Glenn术。结果 :全组无住院死亡 ,术后并发乳糜胸 1例 ,远期无肺动、静脉瘘发生 ,动脉血氧饱和度从术前 ( 78± 11) %上升至术后 ( 92± 6) % ,活动耐力显著增加。结论 :对于难以解剖根治或一期生理矫治的肺血少型复杂先天性心脏病 ,非体外循环下行Glenn术是一种安全、可靠的手术方法。在吻合口前壁用自体心包片加宽 。

Objective To summarize the experiences of off-pump bi-directional Glenn shunt (Glenn shunt) in the treatment of complex congenital heart diseases.Methods Between July 1999 and August 2003,19 patients with complex congenital disease underwent off-pump bi-directional Glenn shunt: unilateral bi-directional cavoatrial Glenn shunt in 17 cases and bilateral bi-directional Glenn shunt in 2 cases. Results No hospitalized mortality in our group. Chylothorax found in 1 patient. No pulmonary arteriovenous fistula occurred. The average SaO 2 was elevated from (78±11)% before surgery to (92±6)% after. The stamina were markedly improved.Conclusion The off-pump bi-directional Glenn shunt is a safe and reliable method in the treatment of such complex congenital heart diseases as hard to be anatomically cured or stage-I physiologically rectified. The widening of the anterior wall of the anastomosis with auto-pericardium can ensure a good patency of the anastomosis.