可调式房间隔造口术在全腔静脉肺动脉连接术中的临床应用

The use of an adjustable interatrial communication in patients nudergoing total cavopulmonary connection

目的介绍可调式房间隔造口技术在全腔静脉肺动脉连接术中临床应用的经验。方法3例紫绀型复杂性先天性心脏病患儿，在施行全腔静脉肺动脉连接术中采用了可调式房间隔造口技术。1例术后中心静脉压＜15mmHg，予以关闭房间隔造口；2例术后中心静脉压＞15mmHg，予以永久性开放房间隔造口（分别为5mm，4mm）。结果3例患儿术后均无严重并发症；2例开放房间隔造口者，术后动脉血氧饱和度维持在90％以上；均于手术12～18天痊愈出院。结论在全腔静脉肺动脉连接术中，采用可调式房间隔造口技术比采用房间隔开窗术具有更大和更多的优点。

Objective To introduce the useof an adjustable interatrial communication in patientsundergoing total cavopulmonary connection (TCPC).Methods From Feb 1998 to April 1998, 3 patientswith complex congenital heart disease undergoing TCPC had placement of an adjustable communication. One patient had the adjustable communicationolosed at the the of operation with central venouspressure < 15 mmHg. Two patients had the adjustable communication opened at the the of operation with central venous pressure > 15 mmHg. Thetwo opened communications were 5 mm and 4 mm indiameter. Results All patients had a smooth postoperative process with no severe surgical complications. Two patients with opened adjustable communication maintained a reduced but acceptable arterialoxygen saturation (> 90%). AN 3 patients weredischarged 12 to 18 days after operation. Conclusion The use of an adjustable interatrial communication for the patients undergoing TCPC may havemany advantages. The TCPC with an adjustableatrial communication may increase the safety of theprocedure.[