CAJ | 학술논문

目的探讨自体肺动脉组织一期矫治主动脉弓病变合并心内畸形的手术方法和治疗效果.方法 1993年4月至2009年11月,共25例主动脉弓病变合并心内畸形的患儿接受了一期矫治手术.男性17例,女性8例;年龄26 d～6.5岁,平均11个月;体质量3.0～14.5 kg,平均12.4 kg.其中6例患儿为主动脉弓缩窄,6例为主动脉弓中断,13例为主动脉弓发育不良.手术技术包括切开肺动脉前壁,切除动脉导管,应用部分自体肺动脉壁重建主动脉弓,重建肺动脉,并同时矫治合并心内畸形.结果 24例患儿术后恢复顺利,1例患儿死于围手术期肺动脉高压危象.随访心脏超声及心脏CT检查证实主动脉弓重建及心内畸形矫治满意.术后未发生神经系统及其他并发症.随访过程中,患儿生长发育正常,主动脉弓无再狭窄.结论自体肺动脉具有生长潜力且柔韧性好,是一种理想的重建主动脉弓的材料.一期矫治手术治疗先天性主动脉弓病变合并心内畸形可以得到满意的结果.
목적 탐토자체폐동맥조직일기교치주동맥궁병변합병심내기형적수술방법화치료효과.방법 1993년4월지2009년11월,공25례주동맥궁병변합병심내기형적환인접수료일기교치수술.남성17례,녀성8례;년령26 d～6.5세,평균11개월;체질량3.0～14.5 kg,평균12.4 kg.기중6례환인위주동맥궁축착,6례위주동맥궁중단,13례위주동맥궁발육불량.수술기술포괄절개폐동맥전벽,절제동맥도관,응용부분자체폐동맥벽중건주동맥궁,중건폐동맥,병동시교치합병심내기형.결과 24례환인술후회복순리,1례환인사우위수술기폐동맥고압위상.수방심장초성급심장CT검사증실주동맥궁중건급심내기형교치만의.술후미발생신경계통급기타병발증.수방과정중,환인생장발육정상,주동맥궁무재협착.결론 자체폐동맥구유생장잠력차유인성호,시일충이상적중건주동맥궁적재료.일기교치수술치료선천성주동맥궁병변합병심내기형가이득도만의적결과.
Objective To analyze the surgical strategy and result of one-stage repair for congenital aortic arch disease associated with other cardiac anomalies. Methods Between April 1993 and November 2009, 25 consecutive patients aged 26 d to 6. 5 years underwent one-stage repair for congenital aortic arch disease with other cardiac anomalies. Among them, 6 patients had coarctation of aorta, 6 patients had interrupted aortic arch, and 13 cases had hypoplasia of aortic arch. The surgical techniques include excision of the anterior wall of pulmonary artery, resection of patent ductus arteriosus tissue, aortic arch reconstruction with autologous pulmonary artery wall, reconstruction of the pulmonary artery and repair of the associated defects. Results Twenty-four patients survived and recovered uneventfully. One patient died of pulmonary hypertention crisis in hospital. The reconstruction of the aorta and the correction of the intracardiac anomalies were proved by postoperative echocardiography and CT scan. There were no neurological or other complications. The follow-up showed that all patients developed normally and there were no restenosis of the aorta arch. Conclusions With the benefits of growth potential and less tension, autologous pulmonary artery tissue is an optimal choice in aortic arch reconstruction. One-stage repair of congenital aortic arch disease associated with other cardiac anomalies can achieve good results.