大动脉调转术22例的初步体会

目的：探讨临床应用大动脉调转术的经验。方法：2000年1月至2001年12月对22例患儿施行大动脉调转术。出生后1个月内手术12例，9h至6岁10例。TGA/IVS10例、TGA/VSD11例、DORV(Taussig-Bing)1例。3例施行姑息性大动脉调转术。结果：手术死亡9例，手术死亡率为40.9％。手术死亡原因为：术中无法脱离体外循环3例、低心排综合征4例、心律失常2例。结论：目前施行大动脉调转术的手术死亡率较高。只有通过严格把握手术适应证、充分进行术前准备，改进大动脉移植技术和严密的术后监护处理等综合措施，才可望提高手术成功率。

Experience of arterial switch operation for complex congenital heart diseases

Objective To review the experie nce of arterial switch operation for complex congenital heart diseases. Methods Twenty two children ranged in age from 9 hours to 6 years with TGA/IVS (10 cases), TGA/VSD (11 cases), and DORV (1 cases) underwent arterial switch operation from Jan. 2000 to Dec. 2001. Among them, 3 children underwent palliative arterial switch operation, with VSD not closed in 2 patients, with VSD patially closed in the other one. Results Nine patients died during hospitalization with a hospital mortality of 40 9%. The causes of death were unsuccess to wear CPB in 3, severe low cardiac output symdrom in 4 and severe arrhythmia in 2. Conclusions The operative mortality of arterial switch operation remains high in our institute at present. In view of current improved surgical techniques and post operative moritoring and management, arterial switch operation may expect an acceptable result.