同种带瓣大动脉重建右心室流出道

目的：应用自行采集和冷冻保存的同种带瓣大动脉（VHC）完成先天性心脏病右心室流出道的重建，并观察其疗效及存在的问题。方法：用VHC材料治疗先天性心脏病95例，90例手术根治，5例行VHC右心室流出道与肺动脉连接姑息手术。结果：院内死亡13例，术后随访68例，死亡2例，均为感染，66例长期生存者中25例胸部X线片示VHC有钙化，多淡主动脉材料，仅5例有轻中度压力阶差（35－60mmHg)。结论：VHC可广泛用于治疗复杂先天性心脏病，程序降温，超低温保存和两步化冻是VHC使用质量的保证，VHC的长期通畅比合成管道好，随植入时间延长钙化率增加，肺动脉VHC优于主动脉，有肺动脉高压者宜尽早手术，为了预防VHC植入后感染，应重视，改善其收集和保存的方法。

Reconstruction of RightVentricular Outflow Tract Using Cryopreserved Valved Homograft Conduit

Objective To reconstruct the right ventricular outflow tract using cryopreserved valved homograft conduit(VHC) and to review the curative effects and remaining problems. Methods Ninety-five patients with complex congenital heart disease were treated from Nov.1989 to Feb.2000.The diagnosis included: transposition of the great artery, double outlet right ventricle, tetralogy of Fallot, persistent truncus arteriosus and aortic stenosis. The corrective operations were performed in 90 cases, and palliative operations in 5 cases. Results The hospital mortality was 13.7%, and 68 cases were followed up from 1 month to 8 years postoperatively with 25 cases showed calcification in VHC by chest X-ray, but only 5 cases had mild to moderate pressure gradient across the conduit. Conclusion VHC can be used to treat almost all kind of congenital heart diseases; aortic VHCs are liable to calcificate than pulmonic VHCs; to keep the VHC in good condition, programed cooling, cryopreserving and two-stage melting were important and should always be concerned with VHC infection.