动脉调转术:单中心10年经验

Arterial switch operation: 10-year experience at a single center

目的总结我院10年来动脉调转手术的疗效及经验。方法2008年9月至2017年7月,我院完成动脉调转手术238例。男193例,女45例;年龄2天~10岁,中位年龄2个月;体质量1.8~20.6 kg,平均(4.2±1.7)kg。大动脉转位合并室间隔缺损91例,室间隔完整型大动脉转位110例,Taussig-Bing畸形37例。合并主动脉弓离断4例,主动脉缩窄20例,冠状动脉壁内走行8例。结果所有患儿均顺利完成手术,其中一期动脉调转术232例,二期动脉调转术6例。住院死亡14例,占5.8%。术后随访1~10年(中位时间46个月),死亡3例,其中2例猝死,可能与肺动脉高压相关,1例因心律失常死亡。10年生存率92.8%。结论随着手术技术的不断改进,动脉调转手术远期结果令人满意,远期再手术风险低。

Objective To summarize the outcomes and experience of arterial switch operation (ASO) in the past 10 years in our center. Methods From September 2008 to July 2017, 238 patients underwent ASO at Guangzhou Women and Children Medical Center for repair of transposition of the great arteries and Taussig-Bing anomaly. There were 193 male and 45 female. Median age at operation was 2 months (2 days to 10 years) and mean body weight was(4.2±1.7) kg (1.8-20.6 kg). There were TGA and VSD 91 cases, TGA/IVS 110 cases, and Taussig-Bing anomaly 37 cases. Among them 24 patients had an aortic arch anomaly. Intramural coronary artery was found in 8 patients. Results All patients successfully completed the operation , one-stage ASO was performed in 232 patients. Two-stage ASO was performed in 6 patients. The mortality was 14.2%. The follow-up duration was 1-10 years (median time, 46 months). There were 3 died. Two suffered sudden death, and another one arrhythmia. 10-year survival rate was 92.8%. Conclusion The outcomes of ASO were satisfactory. The long-term reoperation rate was rare.