Yang Bin, Xu Jing, Zhou Zhiming, Wang Ke, Chen Jianchao, Chen Hongling, Wen Meng, Liang Qiaoru
Department of Cardiac Surgery, The First Affiliated Hospital of Zhengzhou University.
Int Heart J. 2016 Jul 27;57(4):473-6. doi: 10.1536/ihj.15-487. Epub 2016 Jul 11.
To summarize the therapeutic effects of modified double root translocation (MDRT) in the management of congenital heart disease-transposition of great arteries (TGA) with ventricular septum defect (VSD) and left ventricular outflow tract obstruction (LVOTO). From May 2013 to March 2015, we treated 6 patients (4 males, 2 females, aged from 1 year and 8 months old to 5 years old) with complete transposition of great arteries with left ventricular outflow tract obstruction, SaO2 54 ± 7.3%; the outflow velocity of the left ventricular or pulmonary valve measured by Doppler was 4.46 ± 0.15 m/s, and the Nakata index was 217 ± 32 cm(2)/m(2). We carried out a double root translocation operation on these 6 patients.One patient developed low cardiac output syndrome 4 hours after the operation. Extracorporeal membrane oxygenation (ECMO) was performed, but the patient died of multiple organ failure. The other 5 patients all recovered and were discharged from the hospital. During the 3-month to 2-year follow-up period, these 5 patients all demonstrated NYHA Class I or NYHA Class II LVEF (65 ± 2.7) %; 4 had mild pulmonary regurgitation, 1 moderate pulmonary regurgitation; 3 no aortic regurgitation, and 2 micro aortic regurgitation, SaO2 99 ± 0.4%.Modified double root translocation is an effective treatment method in the management of complete transposition of great arteries with left ventricular outflow tract obstruction.
总结改良双根换位术（MDRT）治疗先天性心脏病——大动脉转位（TGA）合并室间隔缺损（VSD）及左心室流出道梗阻（LVOTO）的疗效。2013年5月至2015年3月，我们对6例（男4例，女2例，年龄1岁8个月至5岁）患有完全性大动脉转位合并左心室流出道梗阻、动脉血氧饱和度（SaO2）为54±7.3%的患者进行了治疗；经多普勒测量左心室或肺动脉瓣的流出速度为4.46±0.15m/s， Nakata指数为217±32cm²/m²。我们对这6例患者实施了双根换位手术。1例患者术后4小时出现低心排血量综合征，进行了体外膜肺氧合（ECMO）治疗，但患者死于多器官功能衰竭。其他5例患者均康复出院。在3个月至2年的随访期内，这5例患者的心功能均为纽约心脏协会（NYHA）Ⅰ级或Ⅱ级，左心室射血分数（LVEF）为（65±2.7）%；4例有轻度肺动脉反流，1例有中度肺动脉反流；3例无主动脉反流，2例有微量主动脉反流，SaO2为99±0.4%。改良双根换位术是治疗完全性大动脉转位合并左心室流出道梗阻的一种有效治疗方法。
