应用双向腔静脉-肺动脉吻合术治疗先天性孤立性右心功能不全

Bidirectional cavopulmonary shunt in treatment of isolated congenital right ventricular failure

目的:探讨应用双向腔静脉肺动脉吻合术(BCPS)治疗孤立性右心功能不全的手术方法和效果。方法:3例孤立性右心功能不全的患者(包括2例Ebstein畸形和1例特发性右室发育不良),年龄18～40岁,年龄(32±12)岁,平均体质量(50±8)kg,在非体外循环下施行了BCPS。结果:无手术死亡,术后早期三尖瓣反流量和右房、右室都有不同程度的缩小。长期随访6个月至2年不等,患者心功能保持在Ⅰ～Ⅱ级。结论:BCPS可以给非功能性单心室的孤立性右心功能不全患者带来良好的治疗效果。

Objective： To study the therapeutic effect of bidirectional cavopulmonary shunt（BCPS） on isolated congenital right ventricular failure（IRVF）. Methods： Three patients with IRVF（1 with right ventricular dysplasty and 2 with Ebstein anomaly）, aged 18-40 years, average （ 39±12） years, weighing （50 ± 8） kg, received BCPS without cardiopulmonary bypass. Resuits： There was no operational deaths. Tricuspid valve regurgitation, right atrial and ventricular volume all decreased to different extents after BCPS. Their heart function remained New York Heart Association class Ⅰ or Ⅱ during 6 months to 2 years follow-up. Conclusion： BCPS has good therapeutic effect on patients with isolated right ventricular failure （nonfunctional single ventricle）.