经右腋下切口纠治法乐四联症及室间隔缺损并右心室流出道狭窄

Correction of the Outlet of Right Ventricle through Right Subaxillary Thoracotomy

目的：介绍在体外循环下经右腋下切口法乐四联症及室间隔缺损并右心室流出道狭窄纠治术的经验。 方法：在体外循环下经右腋下切口行法乐四联症及室间隔缺损并右心室流出道狭窄纠治术４９例（右腋下切口组）。与同期常规正中胸切口行同类手术５１例（正中胸切口组）对比。 结果：右腋下切口组手术顺利，临床效果满意。全部病例无手术死亡。 结论：右腋下切口可安全有效地替代正中切口行大部分法乐四联症及室间隔缺损并右心室流出道狭窄纠治术。创伤轻、出血少、恢复快、美容效果好。

Objective: The aim of this study was to present the experience of the total correction of tetralogy of Fallot (TOF)and ventricular septal defect (VSD)with obstructive lesions of the outlet of right ventricle via right subaxillary thoracotomy. Methods: From Sep. 1996 to Jun. 2000, 49 patients underwent total correction of TOF and VSD with obstructive lesions of the outlet of right ventricle through right subaxillary thoracotomy. The age rouged 3. 90 ± 1. 31 (0 .6-10)years, the body weight was 12. 87 ± 1. 32 (6. 5-22)kg. In 20 cases the outlet of right ventricle was enlarged with antogen-ous pericardial patch, 15 with transannular patching, including 11 with transannular patching to pulmonary bifurcation. The cardiopul- monary bypass time was 96.80 ± 12.41 (80-141)with aortic cross-clamping time 71 .00 ± 14.32 (52-108)minutes. Result: There was no operative mortality. Conclusion: Right subaxillary thoracotomy to correcting obstructive lesions of right ventricular outlet was confirmed in clinical practice.