功能性单心室的外科治疗

目的 为了使更多的先天性心脏病患者得到纠治，回顾性总结手术治疗功能性单心室的临床经验。方法 手术纠治127例功能性单心室患者，年龄7个月－12岁，体重7．5－39kg，其中丰唐手术（Fontan operation)72例，半Fontan术3例，双向上腔静脉肺动脉吻合术51例，肺动脉环缩术1例。结果 早期Fontan术19例，死亡11例；改良Fontan术53例，死亡10例；半Fontan术死亡1例；双向上腔静脉肺动脉吻合术死亡4例；总手术死亡率20．5％。结论 功能性单心室必须早期得到纠治，控制肺动脉血流，预防严重缺氧。双向上腔静脉肺动脉吻合术能减少功能性单心室的容量负荷，保持足够的心排血量。改良Fontan术是功能性单心室的最佳手术方案。

Surgical Treatment of Functional Single Ventricle

Objective For the more and more congenital heart disease can be corrected, the purpose of this study was to review our clinical experience in surgical repair of functional single ventricle. Methods One hundred and twenty seven patients with functional single ventricle were repaired. The operative age was 7 months -12 years and the body weight ranged from 7.5 to 39 kg. This series comprised Fontan operation 72 patients, Hemi Fontan operation 3, bidirectional superior cavopulmonary anastomosis 51 and pulmonary artery banding 1. Results There were 11 deaths in Fontan operation, 10 deaths in modify Fontan operations, 1 death in Hemi Fontan operation and 4 deaths in bidirectional superior cavopulmonary anastomosis operations. The total operative mortality was 20.5%. Conclusion The functional single ventricle must be treated early to control pulmonary blood flow and prevent severe hypoxia. The bidirectional superior cavopulmonary anastomosis can reduce the cardiac volume load and keep enough cardiac output . The best surgical treatment of functional single ventricle is modified Fontan operation.