全腔静脉肺动脉连接术治疗复杂先天性心脏病

目的 总结全腔静脉肺动脉连接术治疗复杂先天性心脏病的经验,并对心内隧道和心外管道两种全腔静脉肺动脉连接术术式进行比较.方法 全组32例复杂先天性心脏病,12例行心内隧道全腔静脉肺动脉连接术,20例行心外管道全腔静脉肺动脉连接术.结果 全组患者死亡2例,发生低心排出量综合征8例,10例出现胸腔积液(均治愈),血流动力学满意,术后随访心功能Ⅰ～Ⅱ级,紫绀消失,无心律失常发生.结论 全腔静脉肺动脉连接术是治疗复杂先天性心脏病的一种有效方法,临床效果好,优于传统的Fontan手术;心外管道全腔静脉肺动脉连接术较心内隧道全腔静脉肺动脉连接术操作更简单.Abstract：Objective To summary the experience of total cavopulmonary connection (TCPC) with different methods and study the operative indication, design and therapeutic efficacy. Methods Thirty-two cases of complex cyanotic congenital heart disease were reviewed: 12 cases underwent lateral tunnel and 20 cases extra-cardiac conduit TCPC.Results Two cases were died, and low heart output syndrome occurred in 8 cases, pleural effusion in 10 cases were cured at last. Cyanosis were abscised in all patients and no arrhythmogenesis occured and the heart function improved too. Conclusions The surgical procedures of TPCP is a modus operandi to treat the complex cyanotic congenital heart disease and outweigh the orthodox Fontan procedure. The operating performance of extra-cardiac conduit TCPC is reducing to the lateral tunnel.

Surgical procedures of total cavopulmonary connection in complex cyanotic congenital heart disease

Complex congenital heart disease Vascular prosthesis Total cavopulmonary connection Lateral tunnel Extra-cardiac conduit