重症主动脉缩窄的外科治疗

对合并心内畸形、动脉导管来闭和肺动脉高压的重症主动脉缩窄（CA）患儿3例行体外循环下手术矫治。结果：2例顺利完成手术，1例于术后2h突发急性肺水肿死亡。结论：对该类患儿，除年龄过小、心力衰竭难以控制或技术条件限制外，均宜采用体外循环下一次性同期矫治CA及心内畸形。术中降主动脉插管行下半身灌注，可避免因股动脉插管可能引起的灌注量受限、下肢供血不足、术后缺血性改变及术后插管处狭窄。

Surgery treatment of severe coarctation of aorta

Three coarcation of aorta(CA) severe children combined with internal heart abnormality or PDA,pulmonary hypertension were operatively corrected under extracorporearl circulation (EC). Results:Two patients were smooth going,but one of them died from acute lung edema two hours after operation. Conclusion:As severe young patients with severe coarctation of the aorta were concerned, repairs of CA and the combined abnormalities would be achieved in a one-stage procedure under the support of EC unless the patients were too young,suffered from unrecoverable heart failure or there was restriction on repair technology. Perfusion of the lower body during EC from the cannulation at the desending aorta could avoid the insufficient blood supply to the lower limbs,ischemic changes postoPeratively or artery coarctation at cannula site which caused by cannulation at femoral artery.