大动脉转换术治疗右室双出口合并肺动脉瓣下室间隔缺损

Repair of double-outlet right ventricle with Taussig-Bing by arteries Switch operation

目的 采用大动脉转换术治疗右室双出口合并肺动脉瓣下室间隔缺损 (Taussig Bing综合征 )。方法 5例 2～ 7月龄 ,体重 4 5～ 6 5kg的Taussig Bing综合征病儿经大动脉转换术纠治。其中 2例因肺炎、心衰急诊手术。所有病例在深低温停循环或低流量下行室间隔缺损至肺动脉心内隧道补片方法修补和大动脉转换术方法纠治 ,其中 1例冠状动脉畸形。结果 全组手术死亡 1例 ,该例术后心功能不全、尿量少。余 4例恢复良好 ,术后 10～ 2 4d出院。结论 大动脉转换术治疗Taussig Bing综合征 ,能防止术后左室流出道梗阻 ,避免了心外管道应用 ,减少了术后病死率 。

Objective: To review the clinical experience of arteries Switch operation for double outlet right ventricle with subpulmonary ventricular septal defect(Taussig Bing). Methods: Double outlet right ventricle with subpulmonary ventrical septal defect (Taussig Bing) was corrected by arteries Switch operation in 5 patients. The age was 2 to 7 months. The body weight was 4 5 to 6 5 kg.Two patients associated pneumonia and heart failure received emergency operation. The operative procedure included intraventricular tunnelling and arteries Switch operation under deep hypothermia and circulation arrest or low flow perfusion. Results: One patient died of heart failure and low urine output postoperatively. The other four patients had an uneventful recovery and were discharged 10 to 24 postoperative days. Conclusion: Arteries Switch operation for double outlet Taussig Bing could preventi development postoperative left ventricular outlet tract obstruction and avoid use of extracardiac conduit, hence reduces operative mortality and improves long term result.