Simsek Baran, Ozyuksel Arda, Saygi Murat, Demiroluk Sener, Basaran Murat
Department of Cardiovascular Surgery, Medicana International Hospital, Istanbul, Türkiye.
Department of Cardiovascular Surgery, Biruni University, Istanbul, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2023 Apr 28;31(2):207-214. doi: 10.5606/tgkdc.dergisi.2023.24247. eCollection 2023 Apr.
In this study, we present our experience with the central aortopulmonary shunt technique with interposing a polytetrafluoroethylene graft between main pulmonary artery (end-to-end) and the ascending aorta (side-to-side) in a variety of cyanotic congenital heart defects.
Between January 2019 and June 2022, a total of 10 patients (6 males, 4 females; mean age: 4.3±2.8 months; range, 5 days to 10 months) with hypoplastic central pulmonary arteries who underwent central aortopulmonary shunt procedure were retrospectively analyzed. Demographic characteristics, preoperative, operative, and postoperative data of the patients were recorded. The Nakata indices of the patients were also noted before the procedure, as well as before the second stage of palliation or definitive repair.
Four (40%) patients were operated as the first-step palliation for univentricular circulation. Six (60%) patients had well-developed ventricles and were palliated to be treated with total correction. The median follow-up after the procedure was 12 (range, 8 to 16) months. The mean systemic arterial saturation level at room air was 89.3±2.9% during follow-up. No mortality was observed in any patient.
A central aortopulmonary shunt procedure provides a reliable antegrade blood flow with a relatively non-challenging surgical technique that offers sufficient growth for the hypoplastic and confluent central pulmonary arteries with a very low risk of shunt thrombosis and overflow.
在本研究中，我们介绍了在各种青紫型先天性心脏病中，采用在主肺动脉（端端吻合）和升主动脉（端侧吻合）之间置入聚四氟乙烯移植物的中心性主肺动脉分流术的经验。
回顾性分析2019年1月至2022年6月期间共10例接受中心性主肺动脉分流术的中央肺动脉发育不良患者（6例男性，4例女性；平均年龄：4.3±2.8个月；范围，5天至10个月）。记录患者的人口统计学特征、术前、术中及术后数据。术前以及二期姑息手术或根治性修复术前也记录患者的中田指数。
4例（40%）患者作为单心室循环的一期姑息手术接受了手术。6例（60%）患者心室发育良好，接受姑息治疗以进行根治性矫正。术后中位随访时间为12（范围，8至16）个月。随访期间，静息状态下平均体动脉血氧饱和度水平为89.3±2.9%。所有患者均未观察到死亡。
中心性主肺动脉分流术提供了可靠的顺行血流，手术技术相对简单，为发育不良且融合的中央肺动脉提供了足够的生长空间，分流血栓形成和血流过多的风险非常低。
