合并右肺动脉狭窄的法洛四联症根治性手术治疗

目的 探讨合并右肺动脉狭窄的法洛四联症的根治性手术治疗方法.方法 13例合并右肺动脉狭窄的法洛四联症行根治性手术治疗,其中右肺动脉广泛狭窄7例,行横断升主动脉的法洛四联症根治术；右肺动脉入口狭窄5例,行右肺动脉开口补片扩张的法洛四联症根治术；体肺分流术后右肺动脉中段扭曲狭窄1例,行游离扩张后常规行法洛四联症根治术.结果 全组无手术死亡,无术后低心排,灌注肺发生,术后心功能1级10例,2级3例.结论 右肺动脉狭窄增加了法洛四联症根治术的难度,但对于肺内血管发育良好的患者,法洛四联症根治术仍是首选的手术方式.

The radical surgery for tetralogy of Fallot combined with right pulmonary artery stenosis

Objective To explore the radical surgery for tetralogy of Fallot combined with right pulmonary artery stenosis.Methods Thirteen cases with tetralogy of Fallot combined with right pulmonary artery stenosis accepted radical surgery,among them 7 cases who-had a long right pulmonary artery stenosis accepted aortic transaction for radical surgery of tetralogy of Fallot;5 cases who had the entrance stenosis of the right pulmonary artery accepted right pulmonary artery patch expansion for radical surgery of tetralogy of Fallot;One case who had the distortion and stenosis after pulmonary shunt accepted the radical surgery for tetralogy of Fallot after seperation and expansion.Results There were no operation-related deaths,post-operative low cardic output and perfusion lung occurred for all the cases.Ten cases had grade 1 cardiac function and 3 cases had grade 2,respectively.Conclusion Right pulmonary artery stenosis increased the risks during the radical surgery for tetralogy of Fallot,but it is still the primary operation choice.