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陶西格-宾畸形完全矫正术的短期和中期结果。

Short- and mid-term outcomes of total correction of Taussig-Bing anomaly.

作者信息

Al-Muhaya Mustafa A, Ismail Sameh R, Abu-Sulaiman Riyadh M, Kabbani Mohamed S, Najm Hani K

机构信息

Department of Cardiac Sciences, National Guard Hospital Health Affairs, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

出版信息

Pediatr Cardiol. 2012 Feb;33(2):258-63. doi: 10.1007/s00246-011-0115-5. Epub 2011 Sep 30.

Abstract

Double-outlet right ventricle (DORV)/Taussig-Bing (TB) anomaly is the second most common type of DORV. This study evaluates our experience and outcomes of total correction of DORV-TB anomaly at King Abdulaziz Cardiac Center. We conducted a retrospective study for all cases of TB anomaly repaired between June 2001 and April 2009. Patients were divided into two groups: Group A included patients repaired with arterial switch operation, and group (B) included patients repaired with Rastelli procedure. Thirteen patients with TB anomaly underwent total correction. There were 5 male (38%) and 8 female (62%) patients. Mean age and weight at surgery were 6.8 ± 6 weeks and 3.6 ± 0.7 kg, respectively. Of the 13 patients, 9 (69%) were in group A, and 4 (31%) were in group B. Aortic arch abnormalities were present in 9 patients (69%); abnormal coronary artery patterns were present in 7 patients (54%); side-by-side great arteries were present in 5 patients (38%); dextrotransposition of the great arteries was present in 7 patients (54%); and levo-malposition of the great arteries was present in 1 patient (8%). At postoperative follow-up, 4 patients (31%) had developed either left- or right-ventricular outflow tract (VOT) obstruction requiring surgical and/or catheter intervention. There was no early mortality, but there was 1 late mortality caused by left-ventricle dysfunction. DORV-TB is often associated with other congenital cardiac anomalies. In general, total repair is feasible in the majority of patients with satisfactory results and improved outcome. Residual lesion and development of VOT obstruction can occur, requiring close follow-up and intervention for residual lesion.

摘要

右心室双出口(DORV)/陶西格-宾(TB)畸形是DORV的第二常见类型。本研究评估了我们在阿卜杜勒阿齐兹国王心脏中心对DORV-TB畸形进行完全矫正的经验和结果。我们对2001年6月至2009年4月间所有接受TB畸形修复的病例进行了回顾性研究。患者分为两组:A组包括接受动脉调转术修复的患者,B组包括接受Rastelli手术修复的患者。13例TB畸形患者接受了完全矫正。其中男性5例(38%),女性8例(62%)。手术时的平均年龄和体重分别为6.8±6周和3.6±0.7千克。13例患者中,9例(69%)在A组,4例(31%)在B组。9例患者(69%)存在主动脉弓异常;7例患者(54%)存在异常冠状动脉走行;5例患者(38%)存在并列大动脉;7例患者(54%)存在大动脉右旋位;1例患者(8%)存在大动脉左旋位。术后随访时,4例患者(31%)出现左或右心室流出道(VOT)梗阻,需要手术和/或导管介入治疗。无早期死亡病例,但有1例晚期死亡,原因是左心室功能障碍。DORV-TB常与其他先天性心脏畸形相关。总体而言,大多数患者可行完全修复,结果满意,预后改善。可能会出现残余病变和VOT梗阻,需要密切随访并对残余病变进行干预。

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