修改后的Fontan手术用于复杂形式的双出口右心室的双心室心脏
P Russo1, G K Danielson, F J Puga
1Section of Cardiothoracic Surgery, Mayo Clinic, Rochester, Minnesota.
Circulation
|November 1, 1988
概括
丰坦型手术为复杂的先天性心脏缺陷提供了替代性的手术方法. 低成形的左心室与VSD和AV结异常是Fontan结果的关键风险因素.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 生产性心脏手术 手术 生产心脏手术
- 心脏外科手术 心脏外科手术
背景情况:
- 复杂的双心室心脏与双出口右心室,隔膜缺陷和膜异常的手术管理仍然具有挑战性.
- 传统的心室内道修复可能对这些复杂的解剖学来说不足.
- 丰坦式手术已经成为一种替代性的外科手术策略.
研究的目的:
- 评估复杂双心室心脏和相关异常患者的Fontan型手术的结果.
- 确定影响该患者群体早期和晚期结果的风险因素.
主要方法:
- 对23名患有复杂双心室心脏的患者进行了回顾性分析,这些患者接受了Fontan型手术.
- 程序包括心脏外导管或心肺外导管直接解剖.
- 随访评估包括纽约心脏协会 (NYHA) 的功能分类和死亡率评估.
主要成果:
- 发生了6起医院死亡 (26%) .
- 17名患者的平均随访时间为25个月,表现出良好的功能状态 (NYHA I/II类).
- 累积死亡率为30.4%,在NYHA IV类中有一个晚期死亡.
- 左心室低质,任何心室隔膜缺陷和心房结异常是不良结果的重要风险因素.
结论:
- 在复杂的双心室心脏患者中,当双心室修复是不可行的时,Fontan型手术可能是选择的可行选择.
- 低成形的左心室,心室隔膜缺陷和心房结异常是手术成功和长期预后的关键决定因素.
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