成人法洛四联症的外科治疗

目的总结成人法洛四联症的外科治疗及疗效。方法成人法洛四联症外科治疗78例，所有病例均经右房或右室流出道切口完成疏通和室间隔缺损修补，室间隔缺损均用涤纶补片修补，单纯补片加宽流出道63例，跨瓣环补片15例。结果死亡5例，病死率6．4％；死亡原因：低心排血量综合征4例，心律失常1例；室间隔缺损残余漏3例（3～5mm）；Ⅲ度房室传导阻滞2例。结论成人法洛四联症根治术合理设计，彻底矫正畸形，加强心肌保护及术后管理可取得满意的远期临床效果。

The surgical treatment of tetralogy of fallot in adults

Objective To summarize the experience of surgical treatment for adults with tetralogy of fallot. Methods 78 adult atients with Fallot's tetrad underwent surgical treatment. Longitudinal or oblique right atrial or right ventriculotomy were used to ensure com-plete release right ventricular outflow obstruction and complete ventricular septal defect closure. The ventricular septal defects were closed with Dacron patch. Simply right ventricular outflow tract patches in 63 cases, transannular pateheswere used in 15 patients. Results Five patients died during perioperative periody with the mortality rate of 6.4%, four patients died of low cardiac output syndrome and one of ar-rhythmia;Three patients had residual septal defect (3～5mm) ; Two patients had complete atrial ventricular block and then recovered after one week. Conclusion By careful surgical management, complete deformity correction, satisfactory myocardial protection and postoperative management, the treatment of total correction in adult patients may result in satisfactory long - term clinical effect.