Brawn W J, Mee R B
Victorian Paediatric Cardiac Surgical Unit, Royal Children's Hospital, Australia.
J Thorac Cardiovasc Surg. 1988 Feb;95(2):230-8.
Fifty patients, 21 with transposition of the great arteries plus ventricular septal defect, four with double-outlet right ventricle plus ventricular septal defect, and 25 with transposition of the great arteries plus intact ventricular septum, have undergone anatomic correction. There were four hospital deaths, all in the patients with ventricular septal defects (overall mortality rate 8%). The Lecompte maneuver was used in all patients, and in the last 25 patients the coronary arteries were transposed to medially hinged trapdoor flaps created in the neoaorta. In 10 patients (20%) intraoperative adjustments were necessary to the great vessels and coronary arteries to achieve unobstructed coronary artery flow. There have been no late deaths. Postoperative cardiac catheterization in 19 patients has revealed stenosis on the new main pulmonary artery suture line to be the main early problem. Anatomic correction of transposition (with or without ventricular septal defect) and double-outlet right ventricle septal defect would seem to be a good operative alternative to the Mustard or Senning operation, with the advantage of incorporating the left ventricle into the systemic circulation.
50例患者接受了解剖矫正手术，其中21例为大动脉转位合并室间隔缺损，4例为右心室双出口合并室间隔缺损，25例为大动脉转位合并完整室间隔。有4例患者在医院死亡，均为室间隔缺损患者（总死亡率8%）。所有患者均采用了勒孔特手术，在最后25例患者中，冠状动脉被转移至在新主动脉中创建的内侧铰接活板瓣。10例患者（20%）术中需要对大血管和冠状动脉进行调整，以实现冠状动脉血流通畅。无晚期死亡病例。19例患者术后心脏导管检查显示，新的主肺动脉缝合线处狭窄是主要的早期问题。大动脉转位（伴或不伴室间隔缺损）和右心室双出口室间隔缺损的解剖矫正似乎是比马斯塔德或森宁手术更好的手术选择，其优点是将左心室纳入体循环。
