Barbero-Marcial M, Riso A, Atik E, Jatene A
University of São Paulo Medical School, Heart Institute, Brazil.
J Thorac Cardiovasc Surg. 1990 Feb;99(2):364-9.
A new corrective operation for truncus arteriosus without the use of an extracardiac conduit was performed in seven patients with truncus type I (six patients) or type II (one patient) aged from 2 to 9 months. The common truncus arteriosus was septated with a patch into aortic and pulmonary segments and the ventricular septal defect was closed through a ventriculotomy. A direct anastomosis between the pulmonary arteries and the right ventricle was performed, the anterior wall being constructed with a patch with a monocusp valve. There was one death in the immediate postoperative period. In the surviving six patients the postoperative right ventricular/left ventricular peak systolic pressure ratio was less than 0.51 in five and 0.60 in one with a residual ventricular septal defect. All are in functional class I between 1 and 14 months after the operation. On the basis of these results, we propose this technique for patients with truncus type I or II in the first year of life.
对7例年龄在2至9个月的I型(6例)或II型(1例)共同动脉干患儿,实施了一种不使用心外管道的新型矫正手术。用补片将共同动脉干分隔为主动脉段和肺动脉段,并通过心室切开术闭合室间隔缺损。肺动脉与右心室之间进行直接吻合,前壁用带单尖瓣的补片构建。术后早期有1例死亡。在存活的6例患者中,5例术后右心室/左心室收缩压峰值比小于0.51,1例有残余室间隔缺损者该比值为0.60。术后1至14个月,所有患者心功能均为I级。基于这些结果,我们建议将该技术用于1岁以内的I型或II型共同动脉干患儿。