Department of Cardiothoracic Surgery, Loma Linda University Children's Hospital, Loma Linda, California 92354, USA.
Ann Thorac Surg. 2010 Jan;89(1):e4-6. doi: 10.1016/j.athoracsur.2009.08.079.
The use of right ventricle-to-pulmonary artery conduit improved postoperative hemodynamics and survival in hypoplastic left heart syndrome patients. Proximal conduit anastomosis obstruction prompts hypercyanosis and early bidirectional Glenn connection. We describe modification of the proximal right ventricle-to-pulmonary artery conduit anastomosis to eliminate this complication. Outcomes after Norwood operation using standard Sano (group II) versus modified (group I) right ventricle-to-pulmonary artery conduit anastomosis were evaluated. Group II patients had more hospital readmissions for cyanosis (19 vs 1; p < or = 0.05), the Glenn operation at younger age (4.4 vs 5.6 months), and more proximal stenosis (3 [20%] vs zero; p < or = 0.05) than group I. This modification may eliminate progressive proximal stenosis.
右心室-肺动脉通道的使用改善了左心发育不全综合征患者的术后血液动力学和生存率。近端通道吻合口阻塞会导致高氰血症和早期双向 Glenn 连接。我们描述了近端右心室-肺动脉通道吻合口的改良，以消除这种并发症。评估了使用标准 Sano（II 组）与改良（I 组）右心室-肺动脉通道吻合术的 Norwood 手术后的结果。与 I 组相比，II 组患者因发绀（19 例比 1 例；p≤0.05）、更小年龄的 Glenn 手术（4.4 个月比 5.6 个月）和更多近端狭窄（3[20%]例比零例；p≤0.05）而有更多的住院再入院。这种改良可能消除进行性近端狭窄。
