169例右心室双出口外科治疗的早期结果

Early Surgical Outcomes in Patients With Double Outlet Right Ventricle

目的:分析右心室双出口(DORV)外科治疗的早期结果。方法:2000年1月～2004年9月,169例DORV接受外科手术治疗,其中双心室矫治术103例(60.9%),单心室矫治术50例(29.6%),姑息手术16例(9.5%)。结果:全组住院死亡20例(11.8%),双心室矫治、单心室矫治和姑息手术的死亡率分别是14.6%(15/103)、4.0%(2/50)和18.8%(3/16)。死亡率由2000年的19.5%降到2004年的7.9%。19例(95.0%)死亡病例为DORV合并肺动脉狭窄者。全组7例(4.1%)因并发症做二次手术。结论:DORV的外科治疗可获得良好的早期效果。根据患者的病理形态和病理生理的具体情况选择手术指征,并恰当掌握手术时机,是手术获得成功的关键。

Objective：To analyze early surgical results of double outlet fight ventricle （DORV）. Methods：Between January 2000 and September 2004, 169 patients with DORV underwent surgical treatment, including biventrieular repair in 103 （60.9%） ,single-ventricle repair in 50 （29. 6% ） ,and palliative procedures in 16 （9.5%）. Results ：There were 20 early deaths in the whole series （11.8% ）. The mortality for biventricular repair, single-ventricle repair and palliative procedures were14. 6% ,4. 0% and 18.8%, respectively. The mortality decreased from 19. 5% in 2000 to 7.9% in 2004. Nineteen（95.0% ） hospital deaths occurred in patients with pulmonary stenosis. Reoperations were needed in 7 Patients（4. 1% ） beeanse of surgical complications. Conclusion：Early outcomes were satisfactory for patients with DORV. Careful attention to surgical, anatomy and pathophysiology and proper timing of surgical procedures will enhance the outcomes.