杂交技术在法洛四联症中的应用

Hybrid procedures performed in patients with tetralogy of fallot

目的:总结杂交技术镶嵌治疗儿童法洛四联症(TOF)的经验。方法:外科术前介入治疗:3例有巨大体肺侧支(APCAs)的重症TOF在根治术前予以侧支血管堵塞术。外科术后镶嵌治疗:6例TOF根治术后残余分流,其中4例残余膜周部室间隔缺损,1例残余左室右房通道室间隔缺损,1例残余房间隔缺损,分别予以经导管残余心脏缺损封堵术。结果:3例有巨大APCAs的重症TOF在根治术前予以侧支血管堵塞术后随即进行外科手术,皆获得满意效果。6例TOF根治术后残余分流者行经导管封堵术封堵成功,随访无残余分流及心脏瓣膜异常,未出现心律失常。结论:杂交技术镶嵌治疗伴有巨大APCAs及术后存在残余分流的TOF安全、有效。

Objective：To summarize the experience of hybrid therapy performed in 9 children with tetralogy of fallot （TOF）. Method：Before the total correction of TOF was performed, the collateral arteries were transcatheter closured in 3 cases with huge aorta pulmonary collateral arteries （APCAs）, 6 postoperative cases with residual shunts,4 cases with residual perimembranous ventricular septal defect （VSD）, 1 case with residual left ventricularight atrium communication VSD and 1 case with residual atrium septal defect （ASD）. Result： After transcatheter closure, the total correction were performed in 3 cases with huge APCAs and satisfactory results were achieved. Six cases with residual shunts after total correction were all successfully closed and no residual shunts, no abnormal condition of cardiac valve, no arrhythmia were found during follow up period. Conclusion： Hybrid therapy for TOF with huge APCAs or post-operation residual shunts is safety, simply and effective.