Wang Zhangwei, Ding Nan, Yi Hanlu, Zhu Yaobin, Li Zhiqiang, Yan Daole, Li Xiaofeng, Bai Song
Department of Cardiac Surgery, Beijing Children's Hospital, Capital Medical University, National Children's Medical Center, Beijing, China.
J Card Surg. 2022 Nov;37(11):3769-3775. doi: 10.1111/jocs.16843. Epub 2022 Aug 18.
The sutureless technique was initially used for the treatment of postoperative pulmonary vein obstruction (PVO) in patients with total anomalous pulmonary venous connection (TAPVC). However, as the effectiveness of the sutureless technique has been confirmed and widely developed, the sutureless technique has been used for the primary treatment of high-risk children with TAPVC who are at high risk of PVO. Compared with traditional surgery, the sutureless technique significantly reduces the incidence of postoperative PVO, re-intervention rate due to PVO, and postoperative mortality, but there are potential complications such as pericardial and confluent venous anastomosis, phrenic nerve damage, air embolism. In addition, the sutureless technique is not effective in dealing with the progressive stenosis of the pulmonary veins after sutureless surgery and diffuse stenosis of extrapulmonary proximal veins and intrapulmonary veins. These make the efficacy and safety of this procedure controversial. This paper reviews the research status of the sutureless technique in TAPVC repair at home and abroad over the years.
无缝合技术最初用于治疗完全性肺静脉异位连接（TAPVC）患者的术后肺静脉梗阻（PVO）。然而，随着无缝合技术的有效性得到证实并广泛发展，该技术已被用于对有PVO高风险的TAPVC高危儿童进行一期治疗。与传统手术相比，无缝合技术显著降低了术后PVO的发生率、因PVO导致的再次干预率和术后死亡率，但存在心包和汇合静脉吻合、膈神经损伤、空气栓塞等潜在并发症。此外，无缝合技术在处理无缝合手术后肺静脉的进行性狭窄以及肺外近端静脉和肺内静脉的弥漫性狭窄方面效果不佳。这些使得该手术的疗效和安全性存在争议。本文综述了多年来国内外无缝合技术在TAPVC修复中的研究现状。
