完全性肺静脉异位引流的手术治疗经验

The Experience of Surgical Correction of Total Anomalous Pulmonary Venous Drainage

为评估影响完全性肺静脉异位引流（ＴＡＰＶＤ）手术纠治的因素，本组纳入了２８例在中度低温体外循环和１５例在深低温停循环下手术纠治者。结果手术死亡４例，死亡率９．３％。随访３２例，２例肺静脉回流梗阻分别于术后５个月和２年３个月死亡。结论认为，ＴＡＰＶＤ必须早期手术防止肺血管阻塞性病变；术后定期随访；改进手术方法，防止心房内补片粘连所致肺静脉回流梗阻。

Objective:To Evaluate the risk factors for surgical correction of total anomalous pulmonary venous drainage (TAPVD).Clinical material and method:Forty-three patients with TAPVD underwent surgical correction, under moderate hypothermic cardiopulmonary bypass in 28 and under deep hypothermic circulatory arrest in 15.Result:Four patients died postoperatively with a hospital mortality of 9.3%.Postoperative follow-up of 32 patients found two deaths (5 months and 27 months after surgery,respectively) attributed to obstruction of pulmonary venous drainage.Conclusion:Surgical correction for TAPVD should be performed as earlier as possible to prevent the development of pulmonary vascular obstructive lesions resulting from pulmonary hypertension.Obstruction of pulmonary venous drainage is a serious postoperative complication and intensive follow-up is worthwhile for its early detection.Modification of the operative procedures is required to prevent this fatal complication.