主动脉缩窄的诊断和外科矫正

外科矫正主动脉缩窄２１例。术前漏诊３例。手术分别在浅低温、左心转流、体外循环或常温下进行，共采用８种术式。结果：ｌ８例术后上、下肢压差消失。２１例均痊愈出院，随访１～８年，仅２例成年病人仍有高血压。结论：上肢高血压而下肢低血压或存在差异性发绀者应疑诊本病。病人应于学龄前接受手术。多数可常温阻断主动脉行矫正术，术后应药物控制高血压。

Diagnosis and Surgical Correction of Coarctation of Anta a:An Analysis of 21 Cases

Aim:This paper summarized the experience of surgical treatment of coarctation of aorta.Materials and Methods:This series consisted of 2l cases of coarctation of aorta which was corvectly diagnosed in 18 and misdiagnosed in 3 preoperatively.The operations were performed with mild hypothermia,left heart bypass,cardiopulmonary bypass or normothermia.Eight different surgical techniques were used.Results:There were no pressure gradients demonstrated between the upper and lower limbs after surgical repair in l8 patients.All of the patients recovered and were discharged from the hospital postagorating following up for 1 to 8 years,only 2 adult patients have persistent hypertension.Conclusions:If week pulse in the upper limbs and hypotension in the lower limbs or differential cyanosis are identified,aortic coarctation must be suspected.The optimal age for surgical correction is preschool.A majority of the patients can be operated on under normothermia with cross-clamping of the descending aorta. Postoperative hypertension must be controlled with medication.