Yoshimura N, Yamaguchi M, Oka S, Yoshida M, Murakami H, Kitahara J, Sugi T, Tei T, Kuroe K, Kido S, Tsukuda K, Oshima Y
Department of Cardiothoracic Surgery, Kobe Children's Hospital, Kobe, Japan.
Kyobu Geka. 2003 Apr;56(4):289-93.
Between July, 1988 and November, 2002, 108 patients underwent total cavopulmonary connection (TCPC) at Kobe Children's Hospital. The primary malformation was univentricular heart in 40 tricuspid atresia in 21, mitral atresia in 16, and other complex cardiac defects in the remaining 31. Fenestrated TCPC, staged TCPC, and off-pump TCPC were performed in 39, 26, and 15 high risk patients, respectively. Nitric oxide inhalation was administered in 46 patients. The mean follow-up period was 4.3 years (range, 1 month to 14 years). There were 10 early deaths due to low cardiac output syndrome in 4, thrombosis in 3, tracheal bleeding in 2, and disseminated intravascular coagulation in 1. There were 5 late deaths due to congestive heart failure in 2 patients, arrhythmia in 1, cerebral infarction in 1, and subarachnoid hemorrhage in 1. Late complications included arrhythmia in 17 patients, systemic desaturation caused by abnormal systemic venous channels in 10, pleural or pericardial effusion in 3, chylothorax in 1, and aortic valve incompetence in 1.
1988年7月至2002年11月期间，108例患者在神户儿童医院接受了全腔静脉肺动脉连接术（TCPC）。主要畸形为单心室心脏40例，三尖瓣闭锁21例，二尖瓣闭锁16例，其余31例为其他复杂心脏缺陷。分别对39例、26例和15例高危患者进行了开窗TCPC、分期TCPC和非体外循环TCPC。46例患者接受了一氧化氮吸入治疗。平均随访时间为4.3年（范围1个月至14年）。早期死亡10例，其中4例死于低心排血量综合征，3例死于血栓形成，2例死于气管出血，1例死于弥散性血管内凝血。晚期死亡5例，其中2例死于充血性心力衰竭，1例死于心律失常，1例死于脑梗死，1例死于蛛网膜下腔出血。晚期并发症包括17例心律失常，10例因异常体静脉通道导致的全身氧饱和度降低，3例胸腔或心包积液，1例乳糜胸，1例主动脉瓣关闭不全。
