Hybrid手术治疗法洛四联症合并巨大体肺侧支循环的临床应用价值

Clinical application value of Hybrid procedures in tetralogy of Fallot with major aortopulmonary collaterals

目的评价Hybrid手术治疗法洛四联症(TOF)合并巨大体肺侧支循环(MAPCAs)的临床效果及其临床应用价值。方法对11例复杂型法洛四联症合并巨大体肺侧支循环的病例,均采用先行介入封堵,后行根治性手术的联合治疗。结果共发现巨大体肺侧支循环18支,其中栓堵15支,均未发生造影及栓堵相关并发症。1例出现急性缺氧发作,紧急开胸手术,其余10例均常规行外科根治性手术;术后1例患者出血较多,行二次剖胸探查止血术;2例出现胸腔积液,其余未出现并发症,均痊愈出院。结论 Hybrid手术治疗法洛四联症合并巨大体肺侧支循环是安全稳定的,并具有出血少、损伤小、手术时间短、术后恢复快、并发症少等优点,临床应用价值巨大。

Objective To evaluate the clinical outcomes and application values of Hybrid procedures in tetralogy of Fallot（TOF） with major aortopulmonary collaterals （MAPCAs）. Methods Eleven patients with TOF with APCA were performed with perioperative interventional catheterization, followed by radical surgery. Results Totally 18 loci of MAPCAs were found, 15 of which were embolized successfully without complication of radiography or catheterization. Except for one hypoxia after catheterization, which had emergency surgery, all other patients were performed with conventional radical surgery. After the surgery, 1 postoperative hemorrhage resorted to second operation, and 2 developed pleural effusion. All patients recovered. Conclusion Hybrid procedures for TOF with MAPCAs is safe and feasible, with advantages of less bleeding, operation time, and complications, and quicker recovery, indicating its broad clinical application.