Ilbawi M N, DeLeon S Y, Backer C L, Duffy C E, Muster A J, Zales V R, Paul M H, Idriss F S
Division of Cardiovascular-Thoracic Surgery, Children's Memorial Hospital, Chicago, IL 60614.
J Thorac Cardiovasc Surg. 1990 Sep;100(3):410-5.
A modified approach to the surgical management of corrected transposition of the great vessels with ventricular septal defect and pulmonary stenosis or atresia was used successfully in two patients. The procedure consisted of performing a venous switch operation, directing the blood flow from the morphologically left ventricle (right-sided chamber) into the aorta through the ventricular septal defect and inserting a valved conduit between the left-sided morphologically right ventricle and the pulmonary artery. This approach has several advantages when compared with the traditional surgical management, which consists of closure of the ventricular septal defect and a left ventricular (right-sided chamber) to pulmonary artery conduit. It uses the morphologically left ventricle as the systemic pumping chamber, thereby minimizing long-term ventricular failure. It allows closure of the defect from the right ventricular side of the septum, thus decreasing the prevalence of complete atrioventricular block. It also avoids use of the tricuspid valve as the systemic atrioventricular valve and therefore decreases the chance of postoperative valve regurgitation.
一种改良的手术方法成功应用于两名患有矫正型大动脉转位合并室间隔缺损及肺动脉狭窄或闭锁的患者。该手术包括进行静脉调转手术，将形态学上的左心室（右侧腔室）的血流通过室间隔缺损导入主动脉，并在形态学上的左侧右心室与肺动脉之间插入一个带瓣管道。与传统手术方法（包括室间隔缺损修补及左心室（右侧腔室）至肺动脉管道）相比，这种方法具有多个优点。它将形态学上的左心室用作体循环泵血腔室，从而将长期心室功能衰竭降至最低。它允许从室间隔的右心室侧关闭缺损，从而降低完全房室传导阻滞的发生率。它还避免使用三尖瓣作为体循环房室瓣，因此降低了术后瓣膜反流的几率。
