Chopra P S, Rao P S
Department of Surgery, University of Wisconsin Medical School, Madison.
Indian J Pediatr. 1991 Sep-Oct;58(5):623-40. doi: 10.1007/BF02820180.
Surgical treatment for congenital heart disease has become available over the last five decades. Palliative procedures have been designed to improve physiologic abnormalities, for example systemic artery (or venous) to pulmonary artery shunts of various types to increase the pulmonary blood flow, pulmonary artery constriction (banding) to decrease the pulmonary blood flow, and surgical or transcatheter atrial septostomy to augment intracardiac mixing. These can be performed with a low mortality. The majority of congenital heart defects can be corrected by open heart surgical techniques; some require prior palliation and others can be operated without prior palliative surgery. Recent surgical advances include early total surgical correction for tetralogy of Fallot, arterial switch procedure for transposition of the great arteries, Fontan operation and its modifications for tricuspid atresia and single ventricle, new operations for hypoplastic left heart syndrome, newer prosthetic valves, myocardial preservation and cardiac transplantation.
在过去的五十年里，先天性心脏病的外科治疗已成为可能。姑息性手术旨在改善生理异常，例如各种类型的体动脉（或静脉）至肺动脉分流术以增加肺血流量，肺动脉缩窄（束带术）以减少肺血流量，以及外科或经导管房间隔造口术以增加心内混合。这些手术的死亡率较低。大多数先天性心脏缺陷可以通过心脏直视手术技术得到纠正；有些需要先进行姑息治疗，而有些则无需先进行姑息性手术即可进行手术。最近的外科进展包括法洛四联症的早期完全手术矫正、大动脉转位的动脉调转术、三尖瓣闭锁和单心室的Fontan手术及其改良术、左心发育不全综合征的新手术、更新的人工瓣膜、心肌保护和心脏移植。
