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新生儿和婴儿共同动脉干修复术后的长期结果。

Long-term results after repair of truncus arteriosus communis in neonates and infants.

作者信息

Ullmann M V, Gorenflo M, Sebening C, Ulmer H E, Hagl S

机构信息

Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany.

出版信息

Thorac Cardiovasc Surg. 2003 Aug;51(4):175-9. doi: 10.1055/s-2003-42255.

Abstract

BACKGROUND

We reviewed our experience of truncus arteriosus communis (TAC) repair.

METHODS

Between 05/90 and 10/01, 16 patients underwent complete repair of TAC (primary repair: group I, 12 patients, secondary repair: group II, 4 patients). Age was 2.4 months [5 days-8.8 months] (median [range]) in group I, and 8.3 [5.6-13.5] years in group II. Continuity from the right ventricle to the pulmonary artery was achieved using a valved conduit. All patients had regular follow-up examinations.

RESULTS

There was one early death in each group (12.5%). Follow-up was 9 [1.2-12.7] years. Valved conduit failure occurred in 8 patients (67 %) in group I (group II, 1 patient, 33 %) requiring replacement at 2.5 [0.3-4.3] years (group II, 5.8 years). Severe neo-aortic valve regurgitation after truncal valve repair was observed in one patient, requiring valve replacement at 8.5 years in association with repeat homograft replacement (group I). Actual echocardiographic examination revealed normal ventricular function. Moderate conduit dysfunction was noted in 2 patients (group I).

CONCLUSIONS

Complete repair of truncus arteriosus communis can be performed with excellent long-term results.

摘要

背景

我们回顾了共同动脉干(TAC)修复的经验。

方法

在1990年5月至2001年10月期间,16例患者接受了TAC的完全修复(初次修复:I组,12例患者;二次修复:II组,4例患者)。I组患者年龄为2.4个月[5天至8.8个月](中位数[范围]),II组患者年龄为8.3岁[5.6至13.5岁]。使用带瓣管道实现了从右心室到肺动脉的连续性。所有患者均接受定期随访检查。

结果

每组均有1例早期死亡(12.5%)。随访时间为9年[1.2至12.7年]。I组有8例患者(67%)发生带瓣管道功能衰竭(II组1例患者,33%),需要在2.5年[0.3至4.3年]时进行置换(II组为5.8年)。1例患者在动脉干瓣膜修复后出现严重的新主动脉瓣反流,在8.5岁时需要进行瓣膜置换并再次进行同种异体移植物置换(I组)。实际超声心动图检查显示心室功能正常。2例患者(I组)存在中度管道功能障碍。

结论

共同动脉干的完全修复可以取得优异的长期效果。

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