改良Nikaidoh在合并肺动脉瓣狭窄的Taussig-Bing畸形中的应用

目的 探讨改良Nikaidoh在合并肺动脉瓣狭窄的Taussig-Bing畸形中的应用。方法 采用改良Nikaidoh手术将主动脉和肺动脉根部互换移植，重建左、右心室流出道。观察心脏各部位结构变化，术后恢复及生长发育情况。结果 改良Nikaidoh术后心室与大动脉关系恢复正常，无严重进展性主动脉瓣关闭不全，无中度以上肺动脉瓣反流，无左、右心室流出道梗阻。术后存活5例，1例死于严重心力衰竭及多器官功能不全。随访4个月~7年，患者生长发育改善，血氧饱和度明显上升，发绀消失。结论 改良Nikaidoh在合并肺动脉瓣狭窄的Taussig-Bing畸形中应用可获得解剖根治，并取得良好的手术效果。

Application of Modified Nikaidoh in Taussig-Bing Anomaly with Pulmonary Stenosis

Objective To discuss the application of modified Nikaidoh in Taussig-Bing anomaly with pulmonary stenosis. Methods The modified Nikaidoh procedure was employed to exchange and transplant the aortic and pulmonary roots and rebuild the left and right ventricular outflow tracts. The changes in structure of heart tissues, the post-operative recovery and growth and development of the patients were observed. Results After the modified Nikaidoh procedure, the relationship between the ventricle and artery was recovered to be normal, without the serious progressive aortic valve insufficiency, and medium or above pulmonic valve regurgitation, and left and right ventricular outflow tract obstruction. 5 cases survived after the operation and 1 case died of serious heart failure and multiple organ dysfunction syndrome. According to the follow-up of 4 months to 7 years, the growth and development of patients were improved, with the significant increase in the oxygen saturation and the disappearance of cyanosis. Conclusion The application of modified Nikaidoh in Taussig-Bing anomaly with pulmonary stenosis can achieve the anatomical radical cure and obtain the good surgical effect.