Poirier R A, Berman M A, Stansel H C
J Thorac Cardiovasc Surg. 1975 Feb;69(2):169-82.
Persistent truncus asteriosus is now correctable surgically in patients with favorable anatomy. Given pulmonary arteries of reasonable size arising from any source, successful correction is possible so long as irreversible pulmonary vascular disease has not occurred. Although the majority of children with this defect demonstrate increased pulmonary blood flow, systemic-pulmonary artery shunts can be used. Also, banding of the pulmonary artery, followed subsequently by successful total correction, has been described. Recent reports of a few successful total corrections in infancy, performed with the aid of deep hypothermia and circulatory arrest, may modify the current approach. Although the majority of the reported corrections have involved aortic homograft reconstruction of the pulmonary artery, we strongly favor a synthetic prosthesis containing a heterograft valve. Based upon our clinical experience and this review of the literature, a suggested management protocol is presented.
对于解剖结构适宜的患者，永存动脉干目前可通过手术矫正。只要有来自任何源头的尺寸合理的肺动脉，且尚未发生不可逆的肺血管疾病，成功矫正就是有可能的。虽然大多数患有这种缺陷的儿童表现为肺血流量增加，但也可使用体肺分流术。此外，也有先对肺动脉进行束带术，随后成功进行完全矫正的报道。近期有一些关于在深低温和循环骤停辅助下婴儿期成功进行完全矫正的报道，可能会改变当前的治疗方法。虽然大多数报道的矫正手术都涉及用主动脉同种异体移植物重建肺动脉，但我们强烈倾向于使用含有异种移植物瓣膜的合成假体。基于我们的临床经验和对文献的回顾，提出了一个建议的管理方案。
