应用一期大动脉调转术治疗完全性大血管错位

Primary arterial switch operation used in congenital heart disease with complete transposition of great arteries

目的探讨一期大动脉调转术(Switch术)在完全性大血管错位(D—TGA)中的应用。方法 2004年4月至2009年3月应用一期Switch术治疗完全性大血管错位10例。其中室间隔完整型大血管错位(D-TGA/IVS)5例,大血管错位伴室间隔缺损(D-TGA/VSD)5例;手术平均年龄(39±21.8)d,体重(3.65±1.24)kg。结果手术死亡2例,其余随访3个月-4年,心脏彩超提示心脏功能状况良好,肺动脉轻度残余梗阻1例。结论一期Switch术在完全性大血管错位中的应用可以取得良好的手术效果,及早手术和冠状动脉移植的通畅,是手术成功的关键。

Objective To review and summarize primary arterial switch operation used in complete transposition of great arteries （D-TGA）. Methods Ten patients with complete transposition of great arteries were repaired by primary arterial switch operation during April 2004 to March 2009. There were 5 patients with transposition of great arteries and intact ventricular septum （D- TGA/IVS）, and 5 patients with transposition of great arteries and ventricular septal defect （D-TGMVSD）. The operative age was （39±21.8）days, and weight （3.65±1.24）kg. Results There were 2 deaths. 8 patients were followed-up 3 months to g years.There was one mild pulmonary obstruction. The echocardiography of all patients showed good heart function. Conclusion The primary arterial switch operation used in complete transposition of great arteries had a satisfactory results. The successful operation is the key that switch operation should be performed as early as possible and implantation of the coronary had to he patent.