大动脉转换术治疗新生儿完全性大动脉错位

Arterial Switch operation for complete transposition of great arteries in neonates

目的 回顾总结完全性大动脉错位 (D TGA)的手术治疗。方法 1999年 11月至 2 0 0 1年 8月 ,采用大动脉转换术 (Switch)手术方法纠治新生儿D TGA 16例 ,其中室间隔完整型大动脉错位(D TGA IVS) 6例 ,大动脉错位伴室间隔缺损 (D TGA VSD) 10例。所有病例都在深低温低流量和深低温停循环下行Switch纠治术。结果 Switch手术治疗TGA共 16例 ,其中TGA IVS 6例 ,无死亡 ;TGA VSD 10例 ,死亡 2例 ,均为伴有冠状动脉畸形者。 14例随访 2～ 2 0个月 ,VSD残余漏 1例 ,肺动脉轻度残余梗阻2例 ,14例心功能均良好。结论 Switch手术是D TGA纠治的首选方法 ,但必须早期手术。

Objective: To review and summarize the experience of surgical repair of transposition of great arteries (D TGA). Methods: Sixteen patients with TGA were treated by arterial Switch operation during November 1999 to August 2001. There were 6 patients with transposition of great arteries and intact ventricular septum (D TGA/IVS), and 10 patients with transposition of great arteries and ventricular septum defect (D TGA/VSD). The operation was carried out under deephypothermia circulatory arrest and low flow perfusion. Results: There were 2 deaths with mortality rate of 12.5%. The two deaths occurred in all patients with D TGA/VSD with abnormal coronary arteries. 14 patients were follow up from 2 months to 20 months. There were one residual VSD and two mild pulmonary obstructions. All patients had good heart function. Conclusion: The Switch operation can be considered ass the first choice for surgical repair of D TGA in neonates, and should be performed as early as possible.