Department of Pediatric Cardiac Surgery, Imam Hospital, Tehran, Iran.
J Thorac Cardiovasc Surg. 2010 May;139(5):1183-8. doi: 10.1016/j.jtcvs.2009.10.031. Epub 2009 Dec 28.
We examined the effect of avoiding cardiopulmonary bypass on the early outcome variables after fenestrated extracardiac total cavopulmonary connection.
Between May 2001 and January 2009, 102 patients with univentricular heart physiology underwent fenestrated extracardiac total cavopulmonary connection. Patients were divided into one of 2 groups: the cardiopulmonary bypass (n = 48) group and the no cardiopulmonary bypass (n = 54) group. In both groups there were patients with primary and staged fenestrated extracardiac total cavopulmonary connection. Duration of mechanical ventilation, pleural effusion, hemodynamic status, incidence of arrhythmia, and mortality were compared between the 2 groups.
Both groups were matched, except for more cases of tricuspid atresia in the no cardiopulmonary bypass group (P = .014) compared with other diagnostic morphologies and higher preoperative hemoglobin levels in the no cardiopulmonary bypass group (P = .01). Avoiding cardiopulmonary bypass did not reveal any significant effect on postoperative outcomes. A cardiopulmonary bypass time of more than 120 minutes caused not only a meaningful increase in the mean of mechanical ventilation duration (35 +/- 9.6 vs 13 +/- 2.1 hours, P = .026) but also increased the incidence of mechanical ventilation for more than 12 hours (P = .04). Bypass time of more than 120 minutes did not have influence on any other postoperative variables.
Avoiding cardiopulmonary bypass in fenestrated extracardiac total cavopulmonary connection had no direct effect on the early outcome variables.
我们研究了避免体外循环对腔静脉外全腔静脉吻合术（fenestrated extracardiac total cavopulmonary connection）后早期结果变量的影响。
2001 年 5 月至 2009 年 1 月，102 例单心室心脏生理学患者接受了腔静脉外全腔静脉吻合术。患者分为两组：体外循环组（n = 48）和非体外循环组（n = 54）。两组均有一期和分期腔静脉外全腔静脉吻合术患者。比较两组患者的机械通气时间、胸腔积液、血流动力学状态、心律失常发生率和死亡率。
两组患者除非体外循环组三尖瓣闭锁（tricuspid atresia）患者较多（P =.014）外，其他诊断形态学和非体外循环组术前血红蛋白水平较高（P =.01）外，其他均匹配。避免体外循环对术后结果没有明显影响。体外循环时间超过 120 分钟不仅导致机械通气时间的平均值显著增加（35 +/- 9.6 比 13 +/- 2.1 小时，P =.026），而且增加了机械通气超过 12 小时的发生率（P =.04）。超过 120 分钟的体外循环时间对任何其他术后变量均无影响。
在腔静脉外全腔静脉吻合术中避免体外循环对早期结果变量没有直接影响。
