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传统心房肺连接Fontan术32年疗效卓越。

Traditional Atriopulmonary Connection Fontan with Excellent Outcome for 32 Years.

作者信息

Zhang Yong, Fang Minhua, Wang Zengwei, Wang Huishan

机构信息

Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, Peoples' Republic of China.

出版信息

Thorac Cardiovasc Surg Rep. 2020 Jan;9(1):e18-e20. doi: 10.1055/s-0040-1708528. Epub 2020 Jun 3.

DOI:10.1055/s-0040-1708528
PMID:32509501
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7269721/
Abstract

Although the traditional right atrial-pulmonary artery (RA-PA) Fontan has been replaced by the total cavopulmonary connection, some RA-PA Fontan patients still have good outcome. We report a 37-year-old male who underwent traditional Fontan 32 years ago with the diagnosis of L-transposition of great arteries, subvalvular pulmonary stenosis and cardiac dextroversion. Among the recent CTA, electroconvulsive therapy, catheterization and angiography, pulsatile PA, uniform pulmonary blood, normal PA pressure and resistance were observed in this patient. The traditional RA-PA Fontan may be an alternative surgical procedure.

摘要

尽管传统的右心房-肺动脉（RA-PA）Fontan手术已被全腔静脉-肺动脉连接术所取代，但一些接受RA-PA Fontan手术的患者仍有良好的预后。我们报告一名37岁男性，他在32年前因大动脉L型转位、瓣膜下肺动脉狭窄和心脏右旋而接受了传统的Fontan手术。在最近的CTA、电惊厥治疗、心导管插入术和血管造影检查中，该患者观察到搏动性肺动脉、均匀的肺血、正常的肺动脉压力和阻力。传统的RA-PA Fontan手术可能是一种替代的外科手术方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9ec/7269721/5f5b510bba23/10-1055-s-0040-1708528-i190337crc-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9ec/7269721/d60674d61182/10-1055-s-0040-1708528-i190337crc-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9ec/7269721/086fca2988f3/10-1055-s-0040-1708528-i190337crc-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9ec/7269721/5f5b510bba23/10-1055-s-0040-1708528-i190337crc-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9ec/7269721/d60674d61182/10-1055-s-0040-1708528-i190337crc-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9ec/7269721/086fca2988f3/10-1055-s-0040-1708528-i190337crc-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9ec/7269721/5f5b510bba23/10-1055-s-0040-1708528-i190337crc-3.jpg

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1
Traditional Atriopulmonary Connection Fontan with Excellent Outcome for 32 Years.传统心房肺连接Fontan术32年疗效卓越。
Thorac Cardiovasc Surg Rep. 2020 Jan;9(1):e18-e20. doi: 10.1055/s-0040-1708528. Epub 2020 Jun 3.
2
[Long-term results of atriopulmonary fontan connection for complex cardiac anomalies].[心房肺分流术治疗复杂心脏畸形的长期效果]
Kyobu Geka. 2003 Apr;56(4):262-70.
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Physiological rationale for a bidirectional cavopulmonary shunt. A versatile complement to the Fontan principle.双向腔肺分流的生理学原理。对Fontan原则的一种通用补充。
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Conversion of atriopulmonary or lateral atrial tunnel cavopulmonary anastomosis to extracardiac conduit Fontan modification.将心房肺或侧心房隧道腔肺吻合术转换为心外管道Fontan改良术。
Eur J Cardiothorac Surg. 1999 Feb;15(2):150-7; discussion 157-8. doi: 10.1016/s1010-7940(98)00315-7.
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Exercise capacity and mid-term survival in patients with tricuspid atresia and complex congenital cardiac malformations after modified Fontan-operation.三尖瓣闭锁合并复杂先天性心脏畸形患者改良Fontan手术后的运动能力与中期生存率
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[Anesthesiologic aspects of pregnancy and delivery in a patient following a modified Fontan procedure ].[改良Fontan手术后患者妊娠和分娩的麻醉学要点]
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Total cavopulmonary connection: a logical alternative to atriopulmonary connection for complex Fontan operations. Experimental studies and early clinical experience.全腔静脉-肺动脉连接术：复杂Fontan手术中肺动静脉连接术的合理替代方案。实验研究与早期临床经验。
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Risk factors for atrial tachyarrhythmias after the Fontan operation.Fontan手术后房性快速心律失常的危险因素。
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Pulsed Doppler echocardiographic assessment of portal venous flow patterns in patients after the Fontan operation.Fontan手术患者门静脉血流模式的脉冲多普勒超声心动图评估
Br Heart J. 1993 Jan;69(1):41-6. doi: 10.1136/hrt.69.1.41.

引用本文的文献

1
The prediction and verification of outcome of extracardiac conduits fontan based on computational fluid dynamics simulation.基于计算流体动力学模拟的心脏外管道Fontan手术结果的预测与验证
Front Physiol. 2022 Nov 24;13:1078140. doi: 10.3389/fphys.2022.1078140. eCollection 2022.

本文引用的文献

1
The modified Fontan procedure with use of extracardiac conduit in adults: analysis of 32 consecutive patients.成人使用心外管道的改良Fontan手术：32例连续患者的分析
Ann Thorac Surg. 2014 Dec;98(6):2181-6. doi: 10.1016/j.athoracsur.2014.07.043. Epub 2014 Oct 28.
2
The modern Fontan operation shows no increase in mortality out to 20 years: a new paradigm.现代Fontan手术在长达20年的时间里死亡率并未增加：一种新的模式。
J Thorac Cardiovasc Surg. 2014 Dec;148(6):2517-23.e1. doi: 10.1016/j.jtcvs.2014.07.075. Epub 2014 Aug 4.
3
Surgical repair of tricuspid atresia.
三尖瓣闭锁的外科修复术。
Thorax. 1971 May;26(3):240-8. doi: 10.1136/thx.26.3.240.
4
Total cavopulmonary connection: a logical alternative to atriopulmonary connection for complex Fontan operations. Experimental studies and early clinical experience.全腔静脉-肺动脉连接术：复杂Fontan手术中肺动静脉连接术的合理替代方案。实验研究与早期临床经验。
J Thorac Cardiovasc Surg. 1988 Nov;96(5):682-95.