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肺动脉起源异常左冠状动脉的外科治疗的过去、现在与未来

Past, Present, and Future of Surgical Treatment of Anomalous Left Coronary Artery from the Pulmonary Artery.

作者信息

Wang Zhangwei

机构信息

Department of Cardiovascular Surgery, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 Beilishi Road, Xicheng District, Beijing, China.

出版信息

Pediatr Cardiol. 2024 Jul 8. doi: 10.1007/s00246-024-03575-w.

Abstract

In recent years, with advancements in surgical techniques and the widespread utilization of extracorporeal cardiac assist devices such as extracorporeal membrane oxygenation (ECMO), the treatment outcomes for ALCAPA (Anomalous left coronary artery from the pulmonary artery) have demonstrated significant improvements. However, the surgical indications and methods of ALCAPA, especially the surgical methods of ALCAPA with intramural coronary artery, and whether to treat MR at the same time are still controversial. The long-term prognosis remain discouraging simultaneously, with significant variations in outcomes across different centers. The present review specifically addresses these aforementioned concerns. This article reviews the pathophysiology and classification, diagnosis, indications, surgical strategy and prognosis of ALCAPA. We believe that this review will provide some reference for future researchers and provide new ideas for reducing the adverse prognosis of children with congenital heart disease in future.

摘要

近年来,随着外科技术的进步以及体外膜肺氧合(ECMO)等体外心脏辅助装置的广泛应用,左冠状动脉起源于肺动脉(ALCAPA)的治疗效果有了显著改善。然而,ALCAPA的手术指征和方法,尤其是壁内冠状动脉型ALCAPA的手术方法,以及是否同时治疗二尖瓣反流仍存在争议。同时,长期预后仍然不容乐观,不同中心的治疗结果差异很大。本综述专门针对上述问题进行探讨。本文回顾了ALCAPA的病理生理与分类、诊断、指征、手术策略及预后。我们相信,本综述将为未来的研究人员提供一些参考,并为未来降低先天性心脏病患儿不良预后提供新思路。

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