心外管道全腔静脉肺动脉连接术

目的 报告心管道全腔静脉肺动脉连接术（TECPC）应用经验。方法 横断上腔静脉与右肺动脉端侧吻合，切断下腔静脉前壁，保留原位吻合口，将下腔静脉通过人工血管与主肺动脉吻合，共治疗9例复杂性先天性心脏病，其中1例单心室改良Fontan术后4年频发室上性心动过速而改行TECPC。结果 全组手术后均生存。3例术后出现胸腔积液、乳糜胸并发症、均治愈。血流动力学指标满意，术后随访心功能Ⅰ-Ⅱ级，无心律紊乱发生。结论 TECPC手术操作简单，并发症少，适应证广泛，优于改良Fontan手术和传统的全腔静脉肺动脉连接术。

Total extracardiac cavopulmonary connection

Objective: To report the surgical experience of the total extracardiac cavopulmonary connection (TECPC) for complex congenital heart diseases. Methods: Nine patients with complex congenital heart disease underwent TECPC. Of them, one patient with univentricular heart had modified Fontan operation 4 years ago, has suffered from superaventricular tachyarrthymia. The surgical procedures included a bidirectional cavopulmonary anastomosis with a Gore Tex extracardiac conduit interposition between the inferior vena cava and the main pulmonary artery without transecting the inferior vena cava, and reserving the stoma in situ. 6 patients were operated on without cramping the circulation. Results: There was no operative death. The hemodynamic data were satisfactory. 3 patients had pleural effusions and chylothorax postoperatively. Conclusion: TECPC is superior to the modified Fontan operation and traditional total cavopulmonary connection for complex congenital heart diseases.