法乐四联症合并冠状动脉畸形的外科治疗

目的：先天性冠状动脉畸形少见，但在法乐四联症中则相对多发，给法乐四联症根治术带来了很大困难，并明显地增加其死亡率和并发症发病率。为提高手术成功率和引起外科医生的重视，我们报告了６例此类病人的治疗经验。方法：术前可用超声心动图进行初步筛选，必要时可行心血管造影，以明确冠状动脉走行。手术时根据冠状动脉走行位置选择不同切口，修补室间隔缺损和疏通右心室流出道。结果：除１例无法手术外，５例均成功地实施了根治术。结论：术前诊断直接影响到手术能否成功，术中右心室切口要避免损伤异常冠状动脉

Surgical Treatment of Tetralogy of Fallot With Abnormal Coronary Artery

Objective:Congenital coronary artery anomaly is rear, but is relatively common in tetralogy of Fallot.It makes total correction of tetralogy of Fallot more difficult and increases the mortality and morbidity.To im prove successful rate of the operation and to draw the surgeon's attention, 6 such cases were reported.Methods: Echocardiography was used to screen the patients and angiography if necessary to define dis tribution of the coronary artery. For the closure of VSD and dredge of the out flow tract of right ventricle,incision on right ventricle depended on coronary artery distribution.Results:All of the patients were successfully operated except the unoperable one.Conclusion:Preoperative diagnosis of abnormal coronary artery influences successful rate of the opera tion directly.Damage of the abnormal coronary artery mustt be avoided during right ventriculotomy.