Talwar Sachin, Tiwari Anjali, Sengupta Sanjoy, Choudhury Arindam, Satsangi Amitabh, Choudhary Shiv Kumar
Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India.
Ann Pediatr Cardiol. 2023 Sep-Oct;16(5):354-359. doi: 10.4103/apc.apc_140_23. Epub 2024 Apr 1.
Total cavopulmonary connection (Fontan) without using cardiopulmonary bypass (CPB) may be superior to Fontan on CPB. In the experience of many, a Fontan operation without CPB may be associated with a reduced need for inotropic support, improved outcomes in the postoperative phase including faster time to termination of mechanical ventilatory support, reduced intensive care unit stay, lower volume of pleural and peritoneal effusions, and decreased hospital stay, thereby rendering it more cost-effective. However, the operation is technically more difficult to perform than Fontan on CPB and requires significant modifications of surgical technique and alteration in overall management strategy. In this article, an alternative technique of performing total cavopulmonary connection without CPB is described. Its advantages are briefly discussed.
不使用体外循环（CPB）的全腔静脉肺动脉连接术（Fontan术）可能优于在CPB下进行的Fontan术。根据许多人的经验，非CPB下的Fontan手术可能会减少对血管活性药物支持的需求，改善术后预后，包括缩短机械通气支持终止时间、缩短重症监护病房停留时间、减少胸腔和腹腔积液量以及缩短住院时间，从而使其更具成本效益。然而，该手术在技术上比CPB下的Fontan手术更难实施，并且需要对手术技术进行重大改进以及改变整体管理策略。本文描述了一种不使用CPB进行全腔静脉肺动脉连接的替代技术。并简要讨论了其优点。
