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主动脉弓中断:17例婴儿的经验

Interruption of the aortic arch: experience in 17 infants.

作者信息

Fowler B N, Lucas S K, Razook J D, Thompson W M, Williams G R, Elkins R C

出版信息

Ann Thorac Surg. 1984 Jan;37(1):25-32. doi: 10.1016/s0003-4975(10)60704-7.

Abstract

Between April, 1965, and August, 1982, 17 children ranging in age from 2 days to 4 years were identified as having interruption of the aortic arch and operated on at our institution. There were eight type A interruptions, eight type B interruptions, and one type C interruption. Associated intracardiac anomalies were present in all but 3 patients. These 3 children, who all had type A interruption, underwent repair by mobilization of the aorta and end-to-end reconstruction. The other 14 children had initial palliative operations. The 2 patients in Group 1 had type A interruption with associated ventricular septal defect (VSD), and underwent subclavian artery-aorta anastomosis. In Group 2, the palliative procedure consisted of placement of a Dacron tube graft in 1 patient with type A interruption and associated VSD, and placement of a polytetrafluoroethylene (PTFE) graft, division of the patent ductus arteriosus, and banding of the pulmonary arteries in 11 patients--2 with type A, 8 with type B, and 1 with type C interruption. Ten children (71%) survived initial palliation, 1 of the 2 in Group 1 and 9 of the 12 in Group 2. In Group 2, 5 children had interruption of the aortic arch (4, type B; 1, type C) with associated VSD; among the 4 who survived palliation, 3 subsequently have had successful closure of the VSD and 1 is awaiting closure. Among the patients who had palliative procedures, there are 6 long-term survivors (43%). In the total series, there are 9 long-term survivors (53%).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在1965年4月至1982年8月期间,我们机构共确定了17名年龄在2天至4岁之间的儿童患有主动脉弓中断并接受了手术。其中有8例A型中断、8例B型中断和1例C型中断。除3例外,所有患者均伴有心内异常。这3名均为A型中断的儿童通过主动脉游离和端端重建进行了修复。其他14名儿童接受了一期姑息手术。第1组的2例患者为A型中断合并室间隔缺损(VSD),接受了锁骨下动脉-主动脉吻合术。在第2组中,姑息手术包括:1例A型中断合并VSD的患者植入涤纶人工血管;11例患者(2例A型、8例B型、1例C型中断)植入聚四氟乙烯(PTFE)人工血管、结扎动脉导管未闭并绑扎肺动脉。10名儿童(71%)在一期姑息治疗后存活,第1组的2例中有1例,第2组的12例中有9例。在第2组中,5名儿童患有主动脉弓中断(4例B型、1例C型)合并VSD;在4例存活至姑息治疗后的患者中,3例随后成功闭合了VSD,1例正在等待闭合。在接受姑息手术的患者中,有6名长期存活者(43%)。在整个系列中,有9名长期存活者(53%)。(摘要截短至250字)

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