纠正型大动脉转位double switch术后超声心动图随访

目的:评估双调转术(double switch operation)治疗纠正型大动脉转位(corrected transposition of the great ar-tery,CTGA)的手术效果。方法:35例CTGA行Double switch术,其中Senning+ASO(大动脉调转术)20例,Senning+Rastelli术15例。采用回顾性研究的方法,术后1次或多次行超声心动图随访,平均随访(16.8±20.9)月,最长术后8年,最短术后1月。结果:术后右室心肌工作指数较术前明显下降,术后三尖瓣反流减轻。术后总的肺静脉梗阻发生率5.7%,腔静脉梗阻发生率2.8%,左心流出道梗阻发生率11.4%,右心流出道梗阻发生率11.4%,残余分流发生率17.1%。Senning+Rastelli组左室流出道梗阻发生率较高。结论:Double switch术可改善右室功能,减轻三尖瓣反流,术后残余分流及梗阻发生率较低,是治疗CTGA的理想手术方法。

Echocardiographic follow-up of double switch operation in corrected transposition of the great artery

Objective：To assess the outcome of double switch operation in corrected transposition of the great artery（CTGA）.Methods：Thirty-five patients with CTGA had double switch procedure,an atrial switch plus an aterial switch was performed in 20 patients,an atrial switch plus a Rastelli procedure was performed in 15 patients.Echocardiographic follow-up was performed,and mean follow-up time was（16.8±20.9） months and ranged from one month to eight years.Results：After operation,the myocardial performed index of right ventricle was decreased and the severity of tricuspid regurgitation was relieved.The total rate of pulmonary vein obstruction was 5.7%,the rate of vena cava obstruction was 2.8%,the rate of left ventricle outlet obstruction was 11.4%,and the rate of right ventricle outlet obstruction was 11.4%,the rate of residual shunt was 17.1%.The rate of left ventricle outlet obstruction in Rastelli procedure was high.Conclusion：After double switch procedure,right ventricular function was improved and the severity of tricuspiod regurgitation was relieved,the rate of residual shunt and obstruction was low.There fore,double switch operation was an optimal operation for CTGA.