56例单心室外科治疗经验

Experience of Surgical Treatment of Univentricule(Report of 56 Cases)

目的：总结单心室外科治疗经验。方法：回顾性分析了接受外科治疗的５６例单心室病例。结果：全组手术死亡率１４．２％。其中Ｆｏｎｔａｎ手术３９例，手术死亡率１５．４％；全腔静脉与肺动脉连接术１７例，手术死亡率１１．８％。结论：提高治疗效果的基本经验是严格掌握手术适应证，加强术后监护。行改良Ｆｏｎｔａｎ手术和全腔静脉与肺动脉连接术时，应保证右房与肺动脉吻合口通畅。严密修补房间隔缺损及保护右房完整性，可改善血流动力学。

Aim:To review the experience of surgical management of univentricule(simple ventricule).Clinical material and method:From 1980 to 1996,56 patients with univentricule underwent surgical correction under moderate hypothermic cardiopulmonary bypass.There were 39 males and 17 females with a mean age of 10.8 years(range 2.5 to 34 years).Associated heart abnormalities were atrial septal defect in 18 patients,patent ductus arteriosus in 10 and the other complex heart anomalies in 11.Surgical procedures performed included modified Fontan operation in 39 and total cavopulmonary connection(TCPC) in 17.Results:The operative mortality rate was 15.4% for patients undergoing Fontan procedure and 11.8% for TCPC with overall operative mortality rate of 14.2%.There were 2 late deaths.The heart function were significantly improved in 45 of 46 survivors.Conclusion:The results of this study suggest that surgical outcome is closely related to the following factors:selection of proper surgical candidates,perioperative management and complete correction of cardiac abnormalities.