高危动脉导管未闭的外科治疗(附20例报告)

SURGICAL TREATMENT OF HIGH RISK PATENT DUCTUS ARTERIOSUS

手术治疗高危动脉导管未闭，窗型2例，粗大动脉导管6例，假性动脉瘤1例，动脉导管结扎术后再通2例，合并心内膜炎3例，合并重度肺动脉高压10例，合并房间隔缺损1例，空间隔缺损2例，主动脉瓣下狭窄5例。方法全部在浅低温并行循环下切开肺动脉直视缝闭。结果术后病人均顺利康复出院。随访3个月～3年，心功能I级19例，Ⅱ级1例。结论浅低温并行循环下切开肺动脉直视缝闭动脉导管是治疗高危动脉导管未闭的理想方法，安全可靠，并发症少。

Objective From June 1994 to June 1997,20 patients with high risk patentductus arteriosus (PDA), which included window type (2 cases), large ductus (6 cases ),false aneurysm (1 case),recurrence of ductal patency (2 cases),endocarditis (3 cases ),severe pulmonary hypertension (10 cases) and associated lesions ASD (l case) VSD(2cases ), subaortic obstruction (scases ), underwent surgical treatment in this hospital.Methods in operation, cardiopulmonary bypass and mild hypothermia were first employed in all cases, and then PDA were closed tightly by mattress sutures through the incision of pulmonary artery. Results There were no early deaths later. All patients werefollowed up for a period from 3 months to 3 years, 19 cases were in New Youk Heart Association Functional Class 1 and I case in Class 1. Conclusion The authors realize thatthe operations performed under CPB and mild hypothermia seem to be simple,safe andreliable when dealing with Such high risk patterns.