Bhan Anil, Gupta Manju, Abraham Smartin, Sharma Rajesh, Kothari Shyam Sunder, Juneja Rajnish
Department of Cardiothoracic and Vascular Surgery, Cardiothoracic Center, All India Institute of Medical Sciences, New Delhi, India.
Interact Cardiovasc Thorac Surg. 2007 Apr;6(2):200-3. doi: 10.1510/icvts.2006.138503. Epub 2006 Dec 5.
The aim of this study was to retrospectively analyze our results of both simple and complex aortopulmonary window (APW) repair in infants. From September 1994 to May 2003, 21 infants which included 15 with simple APW (weight 3.9+/-0.8 kg and age 5.1+/-3.7 months) and six with complex APW (weight 4.03+/-1.1 kg and age 5+/-3.8 months) underwent APW repair at the All India Institute of Medical Sciences, New Delhi, India. The approach for APW repair was ligation without CPB in four patients, division and suturing using CPB in one patient, trans-aortic with Goretex patch closure in 11 patients, trans-pulmonary in one patient and trans-window in four patients. The hospital mortality was 13% and 33% for simple and complex APW, respectively. On mean follow-up of 39 months there was no re-operation or late death. An early repair of APW is mandatory to achieve a good surgical result. Trans-aortic repair of APW is the procedure of choice for all APWs, except in the case of large defects where anterior sandwich patch technique (trans-window repair) may be done. In our view, simple ligation without CPB should be avoided due to the possibility of residual APW and distortion of pulmonary artery.
本研究的目的是回顾性分析我们对婴儿单纯性和复杂性主肺动脉窗（APW）修复的结果。1994年9月至2003年5月，21例婴儿在印度新德里全印度医学科学研究所接受了APW修复，其中15例为单纯性APW（体重3.9±0.8kg，年龄5.1±3.7个月），6例为复杂性APW（体重4.03±1.1kg，年龄5±3.8个月）。APW修复的方法包括：4例患者在非体外循环下结扎，1例患者在体外循环下进行分隔和缝合，11例患者经主动脉用Goretex补片修补，1例患者经肺动脉修补，4例患者经窗口修补。单纯性和复杂性APW的医院死亡率分别为13%和33%。平均随访39个月，无再次手术或晚期死亡。早期修复APW对于取得良好的手术效果至关重要。除了大的缺损可能需要采用前夹心补片技术（经窗口修复）外，经主动脉修复APW是所有APW的首选方法。我们认为，应避免在非体外循环下单纯结扎，因为可能会残留APW并导致肺动脉扭曲。
