成人法洛四联症手术矫治疗效分析

Correction of tetralogy of Fallot in 252 adult patients

目的总结成人法洛四联症外科治疗经验及分析近期疗效。方法 2007年1月至2014年5月,在广州军区广州总医院心脏外科住院治疗的252例成人法洛四联症患者,术前完善相关检查,明确诊断后,给予根治手术治疗。其中男143例,女109例,平均(20.5±6.3)岁。结果手术时间(215.2±38.3)min,体外循环时间(99.4±35.6)min,主动脉阻断时间(50.5±18.2)min;术后测压右心室/主动脉0.4±0.2,跨右心室流出道压差均<30 mm Hg;术后呼吸机辅助通气时间(18.6±2.9)h,术后住院时间(13.4±2.4)d。全组住院死亡2例,病死率0.79%。死亡原因均为术后低心排血量综合征继发多脏器功能衰竭。结论外科矫治成人法洛四联症可取得满意的近期疗效。

Objective To evaluate the early results of correction of tetralogy of Fallot in adult patients . Methods From January 2007 to May 2014,252 patients with tetralogy of Fallot,who were older than 14 years of age,underwent complete surgical repair at our institution .There were 143 male and 109 female patients in the study.Results The mean operating time,cardiopulmonary bypass time and aortic cross clamp time were （215.2 ± 38.3）min,（99.4 ±35.6）min and（50.5 ±18.2）min respectively.The ratio of the right ventricular pressure to the aorta pressure measured just after repair was 0.4 ±0.2.All the gradients across the right ventricular outflow tract were less than 30 mm Hg.The mean postoperative mechanic ventilation time was （18.6 ±2.9）h.The mean hospital stay after repair was（13.4 ±2.4）d.There were 2 operating deaths with the operative mortality being 0.79%.Both of the causes of deaths were low output syndrome resulting in multiple organ failure .Conclusions Complete repair of tetralogy of Fallot in adults is feasible with acceptable early mortality .