ASO术中自体心包重建肺动脉根部

目的 评价自体新鲜心包片在ASO术中重建肺动脉根部的疗效.方法 2004年1月至2010年6月,共行ASO术治疗先心病儿63例,均采用裤衩状自体新鲜心包片重建肺动脉根部.术后常规随访,连续多普勒超声心动图测量收缩期肺动脉血流速,二维心脏超声测量肺动脉直径.以同龄健康儿童肺动脉流速、肺动脉直径为对照,评价疗效.结果 治愈出院57例,有效随访49例,时间3个月～6年,平均(22±4)个月.肺动脉流速与正常同龄儿对照整体流速偏快,但根据Bernoulli公式计算,压差均小于30 mm Hg.主肺动脉直径与正常同龄差异无统计学意义.肺动脉瓣关闭不全均为轻度.结论 自体新鲜心包片在ASO术中重建肺动脉根部效果良好.

Abstract：

Objective To evaluate the result of fresh autologuos pericardium for the reconstruction of new pulmonary arterial root in arterial switch operation (ASO). Methods Between January 2004 and June 2010, 63 consecutive infants with congenital heart disease were treated with ASO. A new pulmonary arterial root was reconstructed with a fresh autologuos pericardium which clipped pants-like. The followed up time was 3 months to 6 years after discharge. Patients were reexamined consecutively at 3- and 6-month; 1-, 2- and 6-year. Two-dimensional echocardiography was performed for measuring the pulmonary artery diameter. The pulmonary arterial blood speed was measured by continuous Doppler during systole. The pulmonary flow and the pulmonary artery diameter of healthy children of same age were also measure as control group. Simplified Bernoulli formula was adopted to calculate the pressure gradient through pulmonary artery anastomose for, evaluating whether it had pulmonary stenosis or not. Results Fifty seven infants were cured and discharged. Forty nine patients were finished follow up with a mean duration of( 18 ±4) months. The blood speed in the pulmonary artery anastomosis was 0.70 -2.16 m/s with a mean of (1.31 ±0.40) m/s. No pulmonary stenosis was found with the simplified Bernoulli formula. There was no significant difference regarding the pulmonary diameter and the pulmonary artery flow velocity as compared with the normal children of the same age. Conclusion The fresh autologuos pericardium is reliable for reconstruction of new pulmonary arterial root in ASO.

Fresh autologuos pericardium for reconstruction of new pulmonary arterial root in arterial switch operation

Objective To evaluate the result of fresh autologuos pericardium for the reconstruction of new pulmonary arterial root in arterial switch operation (ASO). Methods Between January 2004 and June 2010, 63 consecutive infants with congenital heart disease were treated with ASO. A new pulmonary arterial root was reconstructed with a fresh autologuos pericardium which clipped pants-like. The followed up time was 3 months to 6 years after discharge. Patients were reexamined consecutively at 3- and 6-month; 1-, 2- and 6-year. Two-dimensional echocardiography was performed for measuring the pulmonary artery diameter. The pulmonary arterial blood speed was measured by continuous Doppler during systole. The pulmonary flow and the pulmonary artery diameter of healthy children of same age were also measure as control group. Simplified Bernoulli formula was adopted to calculate the pressure gradient through pulmonary artery anastomose for, evaluating whether it had pulmonary stenosis or not. Results Fifty seven infants were cured and discharged. Forty nine patients were finished follow up with a mean duration of( 18 ±4) months. The blood speed in the pulmonary artery anastomosis was 0.70 -2.16 m/s with a mean of (1.31 ±0.40) m/s. No pulmonary stenosis was found with the simplified Bernoulli formula. There was no significant difference regarding the pulmonary diameter and the pulmonary artery flow velocity as compared with the normal children of the same age. Conclusion The fresh autologuos pericardium is reliable for reconstruction of new pulmonary arterial root in ASO.