169例右心室双出口外科治疗的早期结果

目的:分析右心室双出口(DORV)外科治疗的早期结果。方法:2000年1月～2004年9月,169例DORV接受外科手术治疗,其中双心室矫治术103例(60.9%),单心室矫治术50例(29.6%),姑息手术16例(9.5%)。结果:全组住院死亡20例(11.8%),双心室矫治、单心室矫治和姑息手术的死亡率分别是14.6%(15/103)、4.0%(2/50)和18.8%(3/16)。死亡率由2000年的19.5%降到2004年的7.9%。19例(95.0%)死亡病例为DORV合并肺动脉狭窄者。全组7例(4.1%)因并发症做二次手术。结论:DORV的外科治疗可获得良好的早期效果。根据患者的病理形态和病理生理的具体情况选择手术指征,并恰当掌握手术时机,是手术获得成功的关键。

Early Surgical Outcomes in Patients With Double Outlet Right Ventricle

Objective:To analyze early surgical results of double outlet right ventricle (DORV).Methods:Between January 2000 and September 2004,169 patients with DORV underwent surgical treatment,including biventricular repair in 103 (60.9%),single-ventricle repair in 50 (29.6%),and palliative procedures in 16 (9.5%).Results:There were 20 early deaths in the whole series (11.8%).The mortality for biventricular repair,single-ventricle repair and palliative procedures were14.6%,4.0% and 18.8%, respectively.The mortality decreased from 19.5% in 2000 to 7.9% in 2004.Nineteen(95.0%) hospital deaths occurred in patients with pulmonary stenosis.Reoperations were needed in 7 Patients(4.1%) becanse of surgical complications.Conclusion:Early outcomes were satisfactory for patients with DORV.Careful attention to surgical anatomy and pathophysiology and proper timing of surgical procedures will enhance the outcomes.