心内直视手术中对漏诊动脉导管未闭的紧急处理

Emergency Management of Misdiagnostic Patent Ductus Arteriosus during Open-Heart Operations

本文报道了9例体外循环心内直机手术中遇有术前未能确诊动脉导管未闭的处理经验，强调了术中深低温、低转流量、不停止体外循环转流、术中需维持良好的左心转流，先经肺动脉切口直视了缝闭动脉导管，随后处理合并的心内病变，以及术中对动脉导管未闭的确认。9例病人除一例死于术后严重免疫性溶血外，全部康复出院，出院时无残流及脑部并发症。

This article reports 9 cases of openheart procedures on cardiac anomalies combined with patent ductus arteriosus (PDA) that bas not been recognized preoperatively.Once confirmed, PDA should be directly sutured via pulmonary artery incision followed by correction of companied intracardiac lesions.Profound hypothermia,low bypass flow rate, non-termination of cardiopulmonary bypass (CPB), maintaining of perfect left heart drainage are emphasized by our experiences.All of the patients were discharged from hospital in good health without residual PDA or intracranial complications, except one postoperative death caused by critical immunologic hemolysis.