Hartyánszky István, Varga Sándor, Csepregi László, Babik Barna, Simon Judit, Havasi Kálmán, Kalapos Anita, Bogáts Gábor
Szívsebészeti Osztály, Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ Szeged, Pécsi út 4., 6720.
Aneszteziológiai és Intenzív Terápiás Osztály, Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ Szeged.
Orv Hetil. 2016 May 22;157(21):820-4. doi: 10.1556/650.2016.30415.
The population with congenital heart disease is increasing and ageing.
The aim of the authors was to examine the outcome of surgical management of congenital heart diseases beyond the age of 60 years.
Between 2013 and 2015, 77 adults were operated (36 younger, and 41 older than forty years, including 12 patients aged over 60 years. The numbers of procedures were as follows (in brackets the number of operations in the three age groups): Ross surgery 5 (3, 2, 0); aortic valve replacement 19 (12, 1, 6); subaortic membrane resection 1 (0, 0, 1); Bentall/ascending aortic plasty 8 (4, 3, 1); myectomy with or without mitral valve replacement in left ventricular outflow obstruction 5 (0, 3, 2); aortic coarctation 1 (1, 0, 0); ligation of ductus arteriosus 2 (1, 1, 0); reconstruction of right ventricular outflow tract with biological valve 4 (0, 3, 1); homograft 5 (5, 0, 0); BioValsalva graft 1 (0, 1, 0); primary reconstruction of complete atrioventricular septum defect 3 (1, 2, 0); valve replacement 2 (1, 1, 0); ventricular septum defect 10 (4, 6, 0); atrial septum defect closure 5 (2, 3, 0); total cavopulmonal anastomosis 1 (1, 0, 0); valve replacement in congenital transposition of great arteries 1 (0, 1, 0), Ebstein operation with valve plasty 2 (0, 1, 1); valve replacement 2 (1, 0, 1).
There was no operative mortality, while early mortality occurred in one patient with total cavopulmonal anastomosis due to multiorgan failure.
Congenital heart defects can be operated beyond the age of 60 years with good results in a tertiary heart centre having great experience in the management of congenital and acquired heart disease.
先天性心脏病患者群体正在增加且老龄化。
作者的目的是研究60岁以上先天性心脏病患者的手术治疗结果。
2013年至2015年间,77名成人接受了手术(36名年龄小于40岁,41名年龄大于40岁,其中包括12名年龄超过60岁的患者。手术种类如下(括号内为三个年龄组的手术例数):罗斯手术5例(3例、2例、0例);主动脉瓣置换术19例(12例、1例、6例);主动脉下膜切除术1例(0例、0例、1例);Bentall/升主动脉成形术8例(4例、3例、1例);左心室流出道梗阻时行肌切除术加或不加二尖瓣置换术5例(0例、3例、2例);主动脉缩窄1例(1例、0例、0例);动脉导管结扎术2例(1例、1例、0例);用生物瓣膜重建右心室流出道4例(0例、3例、1例);同种异体移植物5例(5例、0例、0例);BioValsalva移植物1例(0例、1例、0例);完全性房室间隔缺损一期重建术3例(1例、2例、0例);瓣膜置换术2例(1例、1例、0例);室间隔缺损10例(4例、6例、0例);房间隔缺损修补术5例(2例、3例、0例);全腔肺动脉吻合术1例(1例、0例、0例);先天性大动脉转位时瓣膜置换术1例(0例、1例、0例);Ebstein手术加瓣膜成形术2例(0例、1例、1例);瓣膜置换术2例(1例、0例、1例)。
无手术死亡病例,1例接受全腔肺动脉吻合术的患者因多器官功能衰竭发生早期死亡。
在对先天性和后天性心脏病治疗经验丰富的三级心脏中心,60岁以上的先天性心脏缺陷患者可以接受手术治疗,且效果良好。