136例成人法乐四联症的外科治疗

目的探讨外科治疗成人法乐四联症的经验。方法从１９７５年４月至１９９７年１２月,对１３６例１４周岁以上成人法乐四联症施行根治术,最大年龄为５２岁。室间隔缺损修补材料中,１１２例采用涤纶补片,２４例采用自体心包补片。在１２６例使用补片扩大右心室流出道的病例中,９５例采用牛心包补片,３１例采用自体心包补片。结果住院死亡５例,住院病死率为３６８％。术后发生低心排综合征１７６％、心律失常１４０％、胸内出血需再次开胸止血１１８％、胸腔积液２１３％、心包积液５９％、肺部感染１２５％、感染性心内膜炎２２％。结论成人法乐四联症根治术有其自身特点,通过改进手术技术,加强术后监护处理,可以提高手术成功率

The surgical treatment of tetralogy of fallot in 136 adults

Objective To summarize the experience of surgical treatment of tetralogy of Fallot (TOF) in adults. Method From April 1975 to December 1997, 136 adult patients underwent total corrective repair of tetralogy of Fallot. The patient age ranged from 14 to 52 years old. The ventricular septal defects were closed with Dacron patch in 112 patients, with pericardial patch in 24 patients. A right ventricular outflow patch was required to eliminate right ventricular outflow tract obstruction in 126 patients. Result Five patients died during hospitalization, with a hospital mortality of 3 68%. Four early postoperative deaths were due to severe low cardiac output syndrome. Conclusion In view of current improved and standardized techniques, we conclude that the total corrective repair of TOF may have an excellent result in adult patients.