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[主动脉弓中断。15例患者系列研究]

[Interrupted aortic arch. A series of 15 patients].

作者信息

De Brux J L, Subayi J B, Hvass U, Lamberti A, Azancot A, Pansard Y, Langlois J

机构信息

Service de chirurgie thoracique et cardiovasculaire, Hôpital Bichat, Paris.

出版信息

Arch Mal Coeur Vaiss. 1991 May;84(5):713-9.

PMID:1898207
Abstract

Between 1983 and 1989, 15 children underwent surgical repair of interrupted aortic arch at 1 to 20 days of age. The anatomical form was a Celoria and Patton type B in all patients with an associated perimembranous ventricular septal defect in all but one who had multiple ventricular septal defects, and patent ductus arteriosus. Six children had a retro-esophageal right subclavian artery, two had subaortic stenosis and two had a right-sided descending thoracic aorta. In two children with severe hypoplasia of the ascending aorta the repair was performed in one stage with two deaths due to left ventricular failure. In the other B cases, a two-stage repair was carried out. The reconstruction of the aortic arch varied according to the individual case. All children had pulmonary artery banding. Seven children survived longer than 30 days. Six of them later underwent a complete repair. The only survivors were those patients in whom the neo-aortic arch grew harmoniously. The authors conclude that: a two-stage repair gave disappointing results in this series of consecutive patients, mainly because of the poor quality of the reconstruction of the aortic arch by thoracotomy.

摘要

1983年至1989年间,15名年龄在1至20天的儿童接受了主动脉弓中断的外科修复手术。所有患者的解剖形态均为Celoria和Patton B型,除1例有多个室间隔缺损外,其余均伴有膜周部室间隔缺损和动脉导管未闭。6名儿童有食管后右锁骨下动脉,2名有主动脉下狭窄,2名有右侧胸降主动脉。2例升主动脉严重发育不全的儿童接受了一期修复,2例因左心室衰竭死亡。在其他B型病例中,进行了两期修复。主动脉弓的重建根据个体情况而异。所有儿童均进行了肺动脉环扎术。7名儿童存活超过30天。其中6名后来接受了完全修复。唯一的幸存者是那些新主动脉弓生长协调的患者。作者得出结论:在这一系列连续患者中,两期修复结果令人失望,主要是因为开胸手术重建主动脉弓的质量较差。

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