儿科道型左心室外流通道阻塞的跨和右心室方法:一种替代修改后的Kono Konno的替代方案
Mustafa Kemal Avşar1, Yasin Güzel1, İbrahim Özgür Önsel2
1Department of Cardiovascular Surgery, Pediatric Cardiac Surgery Unit, Faculty of Medicine, Çukurova University, Adana, Türkiye.
针对儿童的道型左心室外流通道阻塞的一种新的手术方法可以避免右心室切除,从而保持心脏功能. 这种跨门和右心房方法为传统的Kono手术提供了安全有效的替代方案.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 遗传性心脏病是一种先天性心脏病.
- 心血管外科心血管外科
背景情况:
- 儿童的道型左心室外流通道阻塞 (LVOTO) 是一个重大的外科手术挑战.
- 传统的Kono或修改的Kono程序涉及右心室切除,可能导致右心室功能障碍和导电问题.
研究的目的:
- 为了评估一个结合的transortic和右心房方法的有效性和安全性,用于治疗道类型的LVOTO在儿科患者.
- 评估这种方法对心室功能的影响,以及重新手术的必要性.
主要方法:
- 在2012年至2023年期间,对26名儿童进行了道型LVOTO维修的回顾性分析.
- 采用了一种结合过风和右心房的方法,并创建了一种阳性心室隔膜缺陷,用于切除和补丁关闭.
- 专注于通过避免腹腔切除来保持右心室功能.
主要成果:
- 没有观察到早期或晚期死亡.
- 平均左心室 - 大动脉梯度显著减少,从67.6 mmHg降至15.8 mmHg (p < 0.0001).
- 高度免于重复手术 (96.2%在5年); 23.1%经历了右束支部阻塞,没有完全的心脏阻塞.
结论:
- 跨门和右心房的方法有效地缓解了儿童道类型的LVOTO.
- 这种右心室节约技术可以保护心室功能,避免与右心室切除相关的风险.
- 它代表了改进的康诺修复的有希望的替代方案,用于儿科LVOTO.
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