四联症根治术的右室流出道重建标准——血液动力学评价与随访

THE CRITERIA FOR RECONSTRUCTION OF RIGHT VENTRICULAR TRACT IN RADICAL TREATMENT OF TETRALOGY OF FALLOT——HEMODYNAMIC EVALUATION AND FOLLOW-UP

四联症根治术的右室流出道梗阻,手术适度的解除(重建术)尚无公认的标准。这是关系到根治术效果的关键问题。本文在动物实验的基础上,通过41例根治术临床观察及监测得出如下用之有效的手术标准:(1)跨环补片的宽度应不超过标准主肺动脉周长的1/3。(2)用患者自体心包片缝成的带单瓣的补片,准确的移植在原有瓣叶的同一水平上。术后肺动脉反流最小,心脏指数最大,术后一年随诊效果最佳。

No definite criterion about suitable correction of ritht ventricular outflow tract obstruction (reconstructive operation) in the treatment of tetralogy of Fallot has been set up. This is a key problem affecting seriously the results of the operation. According to animal experiments and clinical study of 41 patients, we established the effective criteria as follows: (1) The width of the transannular patch must be less than 1/3 of the circumference of the pulmonary annulus. (2) The patch with self-pericardium monocusp sutured accurately at the level of the original cusps, in this way, pulmonary regurgitation is minimum and cardiac index is maximum after operation. The results of the operation were much better than ever before with one-year follow-up.