主肺动脉间隔缺损的外科治疗

目的：总结和交流主肺动脉间隔缺损的外科治疗经验。方法：自1980年1月至2000年8月,作者对18例主肺动脉间隔缺损患者进行外科手术治疗。其中男1例,女7例,平均年龄6．5（2－14岁）。Ⅰ型11例,Ⅱ型3例,Ⅲ型4例。16位患者在中度低温体外循环下完成手术（其中2例应用了深低温停循环技术）。13例经主动脉前壁,3例经肺动脉前壁完成修补术,1例在常温体外循环下,1例在全麻左侧下行结所手术。合并畸形同时进行矫治。结果：3例围术期死亡,15例患者痊愈并经平均108个月的随访,1例存主肺动脉间隔残余漏、余均症状缓解。生活质量改善,结论：早期准确的诊断、合理的外科矫治和术后并发症的防治是主肺动脉间隔缺损外科治疗的关键因素。

Surgical treatment of aorta-pulmonary window

OBJECTIVE: To summarize the experience of surgical treatment of aorta-pulmonary window. METHODS: Between January 1980 and August 2000, 18 patients suffering from aorta-pulmonary window, 11 males and 7 females, with a mean age of 6.5 years (2 approximately 14 years), underwent surgical treatment. Eleven cases were type I, 3 were type II and 4 were type III. Sixteen patients underwent surgical repair under cardiopulmonary bypass at moderate hypothermic temperatures. Deep hypothermic circulatory arrest was used in 2 of them. Closed surgical ligation under cardiopulmonary bypass at normal thermic temperature was performed on 1 case. External division and ligation under general anesthesia through left thorax was performed on 1 case. Thirteen patients underwent surgical repair through the anterior wall of aorta. Surgical repair was performed through the anterior wall of pulmonary artery in 3 cases. Other associated malformations were repaired simultaneously. RESULTS: Three patients died during the peri-operative period. Fifteen patients who survived the operation were followed up for 108 months on average. One patient was noted to have residue shunt on aorta pulmonary window. The other patients showed alleviation of symptoms and improvement of life quality. CONCLUSION: Early diagnosis, suitable surgical procedure and prevention and treatment of postoperative complications are the key factors for treatment of aorta pulmonary window.