非体外循环下双向格林手术

Bidirectional Glenn procedure without cardiopulmonary bypass.

作者信息

Liu Jinfen, Lu Yanan, Chen Huiwen, Shi Zhenying, Su Zhaokang, Ding Wenxiang

机构信息

Department of Pediatric Thoracic and Cardiovascular Surgery, Xinhua Hospital, Shanghai Children's Medical Center, Shanghai Second Medical University, Shanghai, China.

出版信息

Ann Thorac Surg. 2004 Apr;77(4):1349-52. doi: 10.1016/j.athoracsur.2003.06.024.

DOI:10.1016/j.athoracsur.2003.06.024

PMID:15063264

Abstract

BACKGROUND

Whether the bidirectional Glenn procedure is better performed without the support of cardiopulmonary bypass is still a matter for debate. In this paper we discuss the indications and methods for bidirectional Glenn shunt without cardiopulmonary bypass.

METHODS

Twenty patients with complex cyanotic congenital heart defects underwent a bidirectional Glenn shunt without cardiopulmonary bypass between May 2000 and August 2002. There were 10 male and 10 female patients, the mean age was 2.7 +/- 2.6 years (range, 3 months to 11 years), and the mean weight was 11.0 +/- 6.0 kg (range, 4.5 to 32 kg). The mean transcutaneous oxygen saturation was 74.3% +/- 5.7% before the operation. The Glenn shunt was performed under venoatrial or venopulmonary shunt.

RESULTS

All patients survived. Mean superior vena cava clamping time was 24.3 +/- 4.7 minutes, and mean vena cava pressure was 26.9 +/- 5.5 mm Hg during clamping. There were no postoperative neurologic complications. Follow-up echocardiography showed functioning Glenn shunts without any obstruction at the anastomosis.

CONCLUSIONS

The adverse effects of cardiopulmonary bypass could be eliminated by this method. This is an advantage during the postoperative recovery, but patients should be strictly chosen.

摘要

背景

双向格林手术在无体外循环支持下是否能更好地实施仍存在争议。本文讨论无体外循环下双向格林分流术的适应证及方法。

方法

2000年5月至2002年8月，20例患有复杂青紫型先天性心脏病的患者接受了无体外循环下的双向格林分流术。男性和女性各10例，平均年龄为2.7±2.6岁（范围3个月至11岁），平均体重为11.0±6.0千克（范围4.5至32千克）。术前平均经皮血氧饱和度为74.3%±5.7%。格林分流术在腔房或腔肺分流下进行。