Hybrid技术治疗合并体肺侧支的法洛四联症

目的:总结应用Hybrid技术治疗合并较大体肺侧支的法洛四联症的临床结果,分析该联合术式的临床疗效。方法:回顾分析阜外医院1996年1月至2008年12月手术联合栓堵治疗的46例伴有体肺侧支的法洛四联症的临床资料:2007年6月前主要采取手术前、后联合介入栓堵13例(分期组),2007年6月后采用Hybrid技术行术中栓堵33例(同期组)。全组造影发现体肺侧支共89支,成功栓堵70支。结果:同期手术组在体外循环时间、升主动脉阻断时间、呼吸机使用时间、ICU时间及住院时间方面均明显小于分期手术组。同期手术组病死率(6.1%)较分期手术组(31%)低。结论:应用Hy-brid技术治疗合并较大体肺侧枝的法洛氏四联症可降低手术难度,减轻手术创伤,提高手术矫治成功率;术中联合栓堵安全有效,优于术前或术后联合栓堵。

Hybrid procedures for Tetralogy of Fallot with aortopulmonary collateral arteries

Objective：To evaluate the clinical outcomes of Hybrid surgery for Tetralogy of Fallot with major aorto pulmonary collateral arteries（MAPCAs）.Methods：Retrospectively review the clinical data of 46 patients with Tetralogy of Fallot＇s with MAPCAs,which underwent perioperative embolization of MAPCAs from Jan.1996 to Dec.2008.Preoperative and postoperative interventional embolization was adopted in 13 patients before June 2007（Staged group）,embolization during operation was performed in 33 cases from June 2007（One-step group）.89 MAPCAs were found,and 70 were embolized successfully.Results：Compared with the two groups,One-step group had significant differences between time of aorta occlusion, time of CPB,duration of respirator usage,duration of ICU and length of stay.One-step group had lower in-hospital mortality（6.1%）than Staged group（31%）.Conclusion：For patients with dual pulmonary blood supply from MAPCAs and native pulmonary arteries,hybrid surgery can simplify the operation procedures,shorten operation time and alleviate injury.Embolization during operation is better than preoperative and postoperative embolization.