全腔静脉-肺动脉连接术治疗儿童复杂先天性心脏病

目的探讨全腔静脉一肺动脉连接术治疗儿童复杂先心病的方法及疗效。方法年龄0．5～11．5岁的复杂先天性心脏病患儿(单心室伴其他畸形5例，右室双出口伴其他畸形3例，三尖瓣闭锁2例，三尖瓣下移畸形1例)11例施行了心外管道或房内侧壁隧道全腔静脉一肺动脉连接术，采用自体心包6例，采用Gore-Tex管道连接5例，11例中开窗5例。结果全组死亡1例，术后患儿血氧饱和度由65％～85％增加至92％～96％，运动耐力明显增强，心脏容量负荷减轻，血流动力学满意，近期疗效较好。结论全腔静脉一肺动脉连接术操作简捷，血流动力学满意，能有效提高患儿血氧饱和度及减轻心脏容量负荷。术后并发症和病死率较低。

Total cavopulmonary connection in complex congenital heart disease

Objective To evaluate the efficacy of lateral tunnels and extracardiac conduit total cavopulmonary connection (TCPC)on complex congenital heart disease.Methods Six patients underwent lateral tunnels total cavopulmonary connection with autograft pericardium and five patients underwent extracardiac conduit total cavopulmonary connection with 16~22mm of Gore-Tex conduit. The superior vena cava was connected to the right pulmonary artery and inferior vena cava to the main pulmonary artery in all cases. The TCPC fenestration was used in five patients. The intracardiac frame and defects remained unchanged.Results One patient died in postoperative . Others were alive and well. The cardiac volume load was decreased and hemodynamic was satisfactory. The SpO 2 increased from 58%~80% to 92%~95%.Conclusions Lateral tunnels or extracardiac conduit total cavopulmonary connection is a simple and effective procedure. It can efficiently elevate SaO 2 and reduce the cardiac volume load of the patients. Complication and mortality rates are low.