完全性肺静脉异位引流的手术治疗(附44例报告)

目的 探讨完全性肺静脉异位引流（TAPVC）的手术方法和治疗经验。方法对44例TAPVC患者施行手术治疗，其中心上型29例，心内型13例，心下型2例。手术在中度低温体外循环下进行．心上型早期行心脏上翻法吻合、中期行左右房联合切口法，近期改良为心上吻合法。心下型采用心脏上翻纵切口吻合。结果手术死亡2例（心上型和心内型各1例）；心律失常12例，出院时恢复安性心律。结论TAPVC一经确诊．必须立即手术，以防止肺血管阻塞性病变的发生。

Surgical repair of total anomalous pulmonary venous connection

[Objective] To summarize the method and experiences of total anomalous pulmonary venous connection(TAPVC)surgery.[Method] 44 patients with TAPVC(29 cases of supracardiac type,13 cases cardiac type,2 cases infracardiac type) were repaired by using modulating hypothermia cardiopulmonary bypass.For supracardiac type,in early years,the patients were repaired by lifting heart,in 1998-2004,by transversal incision of right atrium and through atrium septal to left atrium,now by supracardiac anastomoses.For infracardiac type,the patients were repaired by lifting heart and vertical incision anastomoses.[Result] Two patients were died one patient of supracardiac type and another of cardiac type.There were 12 cases of arrhythmias occurred after operation and recovered sinus rhythm before discharge.[Conclusion] The operation should be performed soon after confirmed diagnosis to prevent obstruction development in pulmonary vessel.