动脉转位术治疗65例新生儿完全性大动脉错位

Arterial Switch Operation for Transposition of the Great Arteries: Report of 65 Cases in Neonates

目的报告美国西雅图儿童医院１９８９年１０月～１９９２年１０月，为完全性大动脉错位新生儿作动脉转位术６５例，其中伴室间隔完整型４１例，伴室间隔缺损型２４例。方法３６例使用深低温停循环方法，２９例使用深低温低流量方法。结果手术死亡４例（６．１５％），死亡原因均与冠状动脉解剖变异有关。结论动脉转位术是矫正新生儿期室间隔完整型和伴室间隔缺损型完全性大动脉错位最好的手术方法。

Objective From October, 1989 to October, 1992, 65 cases neonates of arterial switch operation for transposition of the great arterias were performed in Seattle Children's Hospital of U.S.A. There were 41 cases with intact ventricular septum(IVS) and 24 cases with ventricular septal defect (VSD). Methods 36 cases used method of deep hypothermia and total circulatory arrest. 29 cases used method of deep circulatory and low flow perfusion. Results There were four operative deaths (6.15%). All four deaths were due to problem with coronary artery implanted because of variation in coronary artery anatomy that we were not able to correct adequately.Conclusion arterial switch operation is the best for neonates transposition of the great arteries with IVS and VSD.