在动脉切换操作后,肺上狭窄的发生率降低
Michael F Swartz1, Ariel Sena, Nader Atallah-Yunes
1University of Rochester, Strong Memorial Hospital, Rochester, NY 14642, USA. michael_swartz@urmc.rochester.edu
Circulation
|September 12, 2012
概括
一种用于动脉切换手术的新技术通过保留本地动脉组织来最大限度地减少上肺狭窄症 (SVPS). 这种大动脉D转移的方法显示出优秀的中期结果,阻塞减少.
科学领域:
- 心血管外科心血管外科
- 儿童心脏病学 儿童心脏病学
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 超脉肺狭窄症 (SVPS) 是动脉切换手术后的一个常见并发症.
- 传统技术涉及Valsalva切除的广泛鼻切除,需要大心周贴片用于肺癌根的重建.
- 这可能会导致术后阻塞在解位.
研究的目的:
- 介绍一项用于动脉切换手术的新技术,该技术可保存本土动脉组织.
- 假设在新肺根解剖中保持本源组织可以减少术后的SVPS.
- 使用这种修改后的方法来评估中期临床结果和SVPS的发病率.
主要方法:
- 对接受大动脉D转移动脉切换的新生儿的回顾性审查 (1996-2009).
- 冠状动脉被收获为 sinus 组织的有限按,保留肺瘤根边缘.
- 对心声图进行了分析,以确定右心室外流通道的阻塞;记录了临床结果.
主要成果:
- 120名患者接受了修改动脉切换手术,生存率为99%.
- 没有观察到冠状动脉损伤.
- 平均随访时间为66个月;新肺根的平均峰值梯度为22.5±5毫米.
- 只有5%的患者需要因阻塞而重新介入.
结论:
- 摘取冠状动脉作为有限按并使用本地动脉组织进行解的技术是安全有效的.
- 这种方法在动脉切换后提供了优秀的中期结果,并且在动脉切换后的肺上狭窄是最小的.
- 在解位保存本源动脉组织似乎可以减少术后阻塞.
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