完全性肺静脉异位引流的外科治疗

Surgical management of total anomalous pulmonary venous drainage

目的总结完全性肺静脉异位引流(TAPVD)的外科治疗经验和体会。方法12例患者采用全身麻醉中度低温体外循环下手术,10例心上型横切右心房和左心房后壁,行肺总静脉与左心房后壁吻合,2例心内型切开ASD与冠状静脉窦口之间的残余房间隔壁,自体心包补片将肺静脉开口与冠状静脉窦隔入左心房。结果患者均手术治愈出院,随访6个月至3年,恢复良好,心功能明显提高。结论完全性肺静脉异位引流手术治疗的关键在于术前正确诊断,术中吻合口应足够大,避免狭窄。

Objective To review the experience of surgical treatment of total anomalous pulmonary venous drainage. Method Twelve cases underwent surgical correction under moderate hypothermic cardiopulmonary bypass. Ten patients had suparcardiae incision, two intracardiac incision. There was no operative death, cardiac functions improved during the follow-up. Results The success of operation depends on correct diagnosis and sufficiency of anastomosis. Conclusion Surgical management of TAPVD have a satisfactory.