同种带单瓣大动脉血管片在肺动脉闭锁一期根治术中的应用

目的 总结在肺动脉闭锁一期根治术中采用具有活性的、液氮深低温保存的同种带单瓣大动脉血管片的经验。方法 1996年10月至2002年5月采用同种带单瓣大动脉血管片连接自体心包片的方法重建右室流出道28例(占同期收治肺动脉闭锁病例的21.88％)，其中合并室间隔缺损17例，室间隔完整11例。结果 住院死亡2例(7.14％)，均为低心排出量综合征。余者发绀消失，活动量增加。术后主要并发症：肺不张3例，感染2例，缺氧性脑病、渗漏综合征、室缺残余分流、二次开胸止血各1例。随访1-24个月，3例肺动脉瓣有少-中量反流，手术效果良好。无晚期死亡及并发症发生。结论 在肺动脉闭锁一期根治术中应用同种带单瓣大动脉血管片跨肺动脉瓣环补片对预防肺动脉关闭不全和反流的近期疗效较好，减少反流的关键是同种带单瓣血管片的制作和手术技术。

Homologous monocuspid valve patch in one stage repair of pulmonary atresia

Objective To review the experience of one stage surgical repair of pulmonary atresia with homologous monocuspid valve patch. Methods From October 1996 to May 2002,twenty-eight patients,4 months to 20 years of age (mean 35.3 months),received surgical repair wih homologous monocuspid valve patch in right ventricular outflow tract reconstruction. 17 patients had ventricular septal defect,others had intact ventricular septum. ResultsTwo patients died of low cardiac output syndrome with a hospital mortality of 7.14%. The leading complications were atelectasis,infection,anoxic encephalopathy,capillary leakage syndrome,residual shunt. Conclusion The repair with homologous monocuspid valve patch for right ventricular outflow tract reconstruction in pulmonary atresia provided good early results and minimizes pulmonary insufficiency. Surgical technique emphasized.