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采用牛颈静脉导管修复永存动脉干的结果。

Outcomes of truncus arteriosus repair with bovine jugular vein conduit.

作者信息

Erek Ersin, Temur Bahar, Suzan Dilek, Aydın Selim, Yıldız Okan, Kırat Barış, Demir İbrahim Halil, Ödemiş Ender

机构信息

Department of Cardiovascular Surgery, Acıbadem University Faculty of Medicine, Atakent Hospital, İstanbul, Turkey.

Department of Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2018 Jul 3;26(3):365-369. doi: 10.5606/tgkdc.dergisi.2018.14841. eCollection 2018 Jul.

Abstract

BACKGROUND

In this study, we aimed to evaluate the outcomes of truncus arteriosus repair in patients undergoing Rastelli type truncus arteriosus.

METHODS

A total of 13 patients (7 males, 6 females; median age 37 days; range, 16 to 60 days) underwent repair of truncus arteriosus using Contegra conduits between January 2011 and March 2 017. P reoperative d iagnosis w as t runcus a rteriosus type 1 (Edwards-Collett) in eight, type 2 in three, type 3 in one, and type 4 in one patient. Contegra conduits used for operations were 14 mm (n=5), 12 mm (n=7), and 16 mm (n=1).

RESULTS

Early death was seen in two patients (15.4%). The median intensive care and hospital stays were 10 (range, 6 to 14) and 20 (range, 14 to 41) days, respectively. The median follow-up was 36 (range, 2 to 66) months. In four patients (31%), the conduit sizes severely increased during follow-up and reached 23 mm in two patients and 20 mm in one patient, and 18 mm in the other patient. Three patients had moderate distal conduit stenosis. Moderate pulmonary insufficiency was detected in four patients and severe pulmonary insufficiency in one patient. Two patients had moderate truncal valve insufficiency and one patient had moderate residual ventricular septal defect. None of the patients needed reoperation.

CONCLUSION

Contegra conduit is a good alternative for repair of truncus arteriosus in infants; however close follow-up is necessary, as distal conduit stenosis and conduit dilatation may develop.

摘要

背景

在本研究中,我们旨在评估接受Rastelli型共同动脉干修复的患者的手术结果。

方法

2011年1月至2017年3月期间,共有13例患者(7例男性,6例女性;中位年龄37天;范围16至60天)使用Contegra导管进行了共同动脉干修复。术前诊断为1型(Edwards-Collett)共同动脉干8例,2型3例,3型1例,4型1例。手术中使用的Contegra导管尺寸为14mm(n = 5)、12mm(n = 7)和16mm(n = 1)。

结果

2例患者(15.4%)早期死亡。重症监护和住院时间的中位数分别为10天(范围6至14天)和20天(范围14至41天)。中位随访时间为36个月(范围2至66个月)。4例患者(31%)在随访期间导管尺寸严重增加,2例患者达到23mm,1例患者达到20mm,另1例患者达到18mm。3例患者存在中度远端导管狭窄。4例患者检测到中度肺动脉瓣关闭不全,1例患者检测到重度肺动脉瓣关闭不全。2例患者存在中度共同动脉干瓣膜关闭不全,1例患者存在中度残余室间隔缺损。所有患者均无需再次手术。

结论

Contegra导管是婴儿共同动脉干修复的良好选择;然而,由于可能发生远端导管狭窄和导管扩张,因此需要密切随访。

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