合并单侧肺动脉缺如先天性心脏病的外科治疗

Surgical Treatment of Congenital Heart Diseases with Unilateral Absence of Pulmonary Artery

9例合并单侧肺动脉缺如的先天性心脏病,其中7例为法乐四联症合并单侧肺动脉缺如,系重症先天畸形。手术均采用带瓣的补片疏通流出道。围术期处理以纠治低心输出量为重点。

Unilateral absence of a pulmonary artery in congenital heart disease may be considered as a risk factor for the surgical treatment of the basic anomaly especialy in cyanotic type of patients. This paper presents 9 such cases: tetralogy of Fallot in 7, dextrocardia and PDA in 1 and truncus arterio-sus with persistent left superior vena cave in one. Absence of left pulmonary artery was present in 7 cases and of right in two. Corrective surgical treatment were performed on 7 patients with tetralogy of Fallot. Two of them died in the early postoperative period. It was recommended that valved extracardiac conduit or woven dacron patch with pericardial monocusp be used for reconstruction of the outflow tract of right ventricle to alleviate the pulmonary regurgitation which was aggravated by higher pulmonary vascular resistance. Appropriate and active management of postoperative low cardiac output is also vital important.