心室双出口手术治疗临床研究

目的：探讨心室双出口的手术治疗效果。方法：回顾性分析72例心室双出口病人手术治疗方法及治疗效果。右室双出口71例中SDD型64例，ILL型3例，SDL型3例，IDD型1例；左室双出口1例（ILD型）。采用左心室-主动脉心内隧道连接61例，全腔静脉-肺动脉连接2例，左心室-主动脉心内隧道并右心室-肺动脉心外管道连接3例，Glenn分流6例。结果：死亡2例。1例术后3个月发现残余室间隔缺损，予再次手术缝合。余者效果良好，无远期死亡及相关并发症发生。结论：根据心室双出口的不同类型，选择最佳手术方式及掌握手术时机是成功的重要因素，重建通畅良好的左或右室流出道是提高手术成功率的关键因素。

Surgical treatment of double outlet ventricle

Objective: To study the results of surgical treatment for double outlet ventricle. Methods: The results of 72 cases of double outlet ventricle were retrospectively analyzed. Results: There were 71 cases of double outlet right ventricle, including 64 cases of type SDD, 3 type ILL, 3 type SDL, 1 type IDD. Only one case was double outlet left ventricle type ILD. Surgical procedures included left ventricle-aorta intraventricular tunnel connection in 61 patients, total cava-pulmonary artery connection in 2, left ventricle-aorta intraventricular tunnel and right ventricle-pulmonary artery extracardial tube repaired in 3. Six cases underwent bi-directional Glenn procedure. Two cases died from operation. Residue shunt of VSD was observed in one case and re-operation was done to repair the shunt. There were no long-term death and other complications. Conclusion: It is important to choose the right time and proper procedure. Reconstruction left and right ventricle is the essential factor to the surgical success.