CAJ | 학술논문

目的回顾性总结我院采用大动脉转换术(ASO)治疗完全性大动脉错位的疗效.方法 2004年4月至2008年12月,应用大动脉转换术治疗完全性大动脉错位(D-TGA)27例,其中<2周11例,<4周8例,<6个月4例,<1岁3例,＞1岁1例.室间隔完整型大动脉错位(D-TGA/IVS)19例,其中快速二期4例.大动脉错位合并室间隔缺损(D-TGA/VSD)8例.所有患者均在经鼻气管插管全麻深低温低流量体外循环下行ASO.结果全组死亡5例,病死率18.5%.其中TGA/IVS 15例,死亡2例,1例为肺出血,1例为重度黄疸、肝功能衰竭.TGA/IVS快速二期4例,无死亡.TGA/VSD 8例,死亡3例,2例合并冠状动脉畸形,1例死于出血.22例随访3～56个月,心功能均正常,残余主动脉轻度梗阻1例,肺动脉轻度梗阻3例.结论大动脉转换术治疗TGA效果良好,适当的手术时机和冠状动脉的完美转移是手术成功的关键.
목적 회고성총결아원채용대동맥전환술(ASO)치료완전성대동맥착위적료효.방법 2004년4월지2008년12월,응용대동맥전환술치료완전성대동맥착위(D-TGA)27례,기중<2주11례,<4주8례,<6개월4례,<1세3례,＞1세1례.실간격완정형대동맥착위(D-TGA/IVS)19례,기중쾌속이기4례.대동맥착위합병실간격결손(D-TGA/VSD)8례.소유환자균재경비기관삽관전마심저온저류량체외순배하행ASO.결과 전조사망5례,병사솔18.5%.기중TGA/IVS 15례,사망2례,1례위폐출혈,1례위중도황달、간공능쇠갈.TGA/IVS쾌속이기4례,무사망.TGA/VSD 8례,사망3례,2례합병관상동맥기형,1례사우출혈.22례수방3～56개월,심공능균정상,잔여주동맥경도경조1례,폐동맥경도경조3례.결론 대동맥전환술치료TGA효과량호,괄당적수술시궤화관상동맥적완미전이시수술성공적관건.
Objective To review the effect of arterial switch operation (ASO) for complete transposition of great arteries in our hospital from April 2004 to December 2008. Methods Twerty - seven cases of complete transposition of great arteries (TGA) were repaired by the ASO between April 2004 and December 2008. There were 19 patients with trans-position of great arteries with intact ventricular septal (TGA/IVS), age from 6 to 120 [average (21.7±13.6)] days, weight from 2.8 to 5.4 (3.6±0.5) kg. And there were 8 patients of transposition of great arteries with w;ntricular septald defeet (TGA/VSD), age from 9 to 72 [average (41.0±26.5)] days,weight from 3. 1 to 5.3 average (3.8±0.4)kg,ex-cept one case of 4 years. All cases underwent ASO under ultrafiltration and modified uhrafihration, deep hypothermic low flow CPB. Results There were 5 deaths (2 from TGA/IVS group and 3 from TGA/VSD group) and no death in rapid two - stage ASO. The hospital mortality was 18.5%. 22 survivors were followed - up. One patient had residual ascending a-orta obstruction and 3 patients had mild pulmonary obstruction. Conclusions Arterial switch operation can be performed in congenital transposition of great artery. The key is operative opportunity and perfect transfer of the coronary arteries.