主动脉缩窄矫治术的体外管理策略

Administration of cardiopulmonary bypass in surgery for coarctation of the aorta

目的总结主动脉缩窄(COA)矫治术的体外循环管理经验。方法回顾性分析在体外循环下采用胸部正中切口一期矫治COA及合并的其它心内畸形24例的临床资料。结果24例患儿中1例单纯COA,23例同时合并其它心内畸形。除1例为分期手术外,其他23例均采取体外循环下深低温方法一期矫治。死亡3例,其中2例死于低心排出量综合征,1例死于主动脉插管意外。术后发生短暂肝肾功能障碍3例,短暂高血压2例。所有病例术后无肾功能不全或截瘫等严重的体外循环并发症。结论采用深低温转流技术对矫治COA和合并畸形是安全有效的。

Objective To sum up the experiences of cardiopulmonary bypass（CPB） in surgery for coarctation of the aorta（COA）.Methods The clinical data of 24 cases of COA with intracardiac anomalies one-stage operated with median sternotomy and cardiopulmonary bypass were analyzed retrospectively.Results Of the 24 cases,1 case was the simple COA,others were complicated with introcardiac anomalies.Twenty-three patients were treated with one-stage operation in deep hypothermia of CPB,and 1 patient with staged operation.Three patients died（2 for low cardiac output and 1 for accident of aorta canula）.Three cases had temporary hepatosis and renal dysfunction.Two cases had temporary hypertension.No paraplegia,kidney failure or other serious complications related to CPB in all cases.Conclusion Deep hypothermia technique is safe and effective for the surgery of the COA and associated cardiac anomalies.