法乐四联症合并一侧肺动脉缺如的外科治疗

Correction of tetralogy of fallot in patients with a sin-gle pulmonary artery

法乐四联症合并一侧肺动脉缺如临床少见。作者单位自１９６６年５月以来共收治的法乐四联症２２９４例，其中合并一侧肺动脉缺如２３例（约占１％），左肺动脉缺如１９例，右肺动脉缺如４例。９例应用右心室到肺动脉心外管道，其余的应用带单瓣右心室流出道补片。手术死亡２例，手术死亡率为８．７％。存活者术后恢复顺利，远期疗效较满意。作者认为，四联症合并一侧肺动脉缺如应选用带单瓣右心室流出道补片，如有异常冠状动脉或肺动脉闭锁则用右心室到肺动脉同种带瓣主动脉心外管道。

Abstract2249 patients underwent correction of tetraiogy offallot in our department. 23 of them were with unilat-eral absence of pulmonary arterv,19 absence of theleft pulmonary artery, 4 absence of the fight pul-monary artery. The age at operation ranged from 4 to21 years. Valve-containing conduits were used in 9 pa-tiens and right ventricular outflow patch in 14 pa-tients. There were two operative death who both hadhypoplasia of the left ventricle. All survivors had goodearly and late results. Outflow patch with a singlevalve should be used in tetralogy of fallot with a singlepulmonary artery and pulmonary valve ring stenosis.Aorticvalved homograft conduit is suit for the patientwith anomalous coronary or pulmonary atresia.