Dong Shuo, Yan Jun, Xu Haitao, Duan Yabing, Liu Chun
Department of Pediatric Cardiac Surgery, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037, People's Republic of China.
38 Department of Cardiopulmonary Bypass, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037, People's Republic of China.
J Cardiothorac Surg. 2019 Apr 27;14(1):82. doi: 10.1186/s13019-019-0904-0.
This study sought to summarize the clinical experience of surgical treatment of anomalous origin of pulmonary arteries from the ascending aorta (AOPA) in Fuwai hospital.
Fifty-two patients (28 males, 17.2 ± 27.2 months old and 8.7 ± 10.2 Kg weight) who have AOPA undertook surgical treatment between 1998 and 2017 were reviewed in this study, 47 out of 52 are anomalous origin of the right pulmonary artery (AORPA), among the rest of the patients are anomalous origin of left pulmonary artery (AOLPA). 27 out of 52 associate with simple cardiac abnormalities, 20 out of 52 associate with complex cardiac malformations, the remaining 5 patients without cardiac abnormalities. Among all patients who underwent surgical treatment, the direct end-to-side anastomosis strategy was applied in 26 patients, autologous pericardial-homograft patch and aortic flap were employed in 20 patients, and synthetic graft was used in 6 patients.
No patient died during the perioperative period. 50 out of 52 patients were followed-up for 100.1 ± 70.9 months. The rate of pulmonary arterial free restenosis for 2 years, 5 years, and 10 years is 98.0, 96.0 and 92.0%, respectively.
The correct diagnosis and appropriate surgical treatment for AOPA could obtain excellent early and medium-term result.
本研究旨在总结阜外医院外科治疗升主动脉起源肺动脉异常(AOPA)的临床经验。
回顾性分析1998年至2017年间接受手术治疗的52例AOPA患者(男28例,年龄17.2±27.2个月,体重8.7±10.2 kg),其中52例中有47例为右肺动脉起源异常(AORPA),其余为左肺动脉起源异常(AOLPA)。52例中有27例合并简单心脏异常,20例合并复杂心脏畸形,其余5例无心脏异常。在所有接受手术治疗的患者中,26例采用直接端侧吻合策略,20例采用自体心包-同种异体补片和主动脉瓣,6例采用人工血管。
围手术期无患者死亡。52例患者中有50例获得随访,随访时间为100.1±70.9个月。2年、5年和10年的肺动脉无再狭窄率分别为98.0%、96.0%和92.0%。
对AOPA进行正确诊断并采取合适的手术治疗可获得良好的早中期效果。