双向腔静脉肺动脉吻合术治疗小儿复杂型先天性心脏病

Surgical treatment of pediatric complex congenital heart disease by bidirectional cavopulmonary shunt

目的 回顾性总结 5 1例双向腔静脉 肺动脉吻合术 (BCPS)的经验。 方法 对 2 2例单心室、2例三尖瓣闭锁和 2 7例不能行双心室修复的复杂型先天性心脏病患者行BCPS。患者手术时年龄 7个月～ 14岁 ,平均 (4 7± 3 1)岁 ;体重 7 5～ 42 0kg ,平均 (15 2± 5 7)kg。其中 19例行单侧腔静脉 肺动脉吻合 ,32例行BCPS。 结果 2种吻合方法各死亡 2例 ,病死率分别为 10 4%和 6 1% ,手术总病死率 7 7%。本组患者术后随访 3个月～ 5年 ,7例患者青紫较出院时加重。 结论 BCPS能减轻功能性单心室的容量超负荷、改善房室瓣返流、防止肺血管阻塞性病变的发生 ,是复杂型先天性心脏病 。

Objective[WT5”BZ] To sum up the experience in 51 childrens with complex congenital heart disease treated by bidirectional cavopulmonary shunt (BCS). [WT5”HZ]Methods[WT5”BZ] In the 51 patients their age ranged from 7 months to 14 years (average 4 7±3 1), and their weight raried from 7 5 to 42 0 kg(average 15 2±5 7). Twenty-two patients had single ventricle and 29 patients had complex anatomy that can′t be corrected by biventricle repair. [WT5”HZ]Results[WT5”BZ] There were two deaths in 19 patients receiving single BCS (10 53%) and two deaths in 32 patients receiving bileteral BCS (6 06%). The total operative mortality was 7 69%. Seven patients had progressive cynosis during the follow up for 3 months to 5 years. [WT5”HZ]Conclusion[WT5”BZ] BCS can relieve volume overload, AV valve regugitation and prevent pulmonary vascular obstructive disease in functional single ventricle. This can be used in high risk Fontan patients and patients with complex congenital heart disease that can′t be corrected by biventricle repair. [WT5”HZ]