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用于大动脉转位、室间隔缺损和左心室流出道梗阻的Rastelli手术。41例患者(1971年至1978年)的早期和晚期结果。

Rastelli procedure for transposition of the great arteries, ventricular septal defect, and left ventricular outflow tract obstruction. Early and late results in 41 patients (1971 to 1978).

作者信息

Moulton A L, de Leval M R, Macartney F J, Taylor J F, Stark J

出版信息

Br Heart J. 1981 Jan;45(1):20-8. doi: 10.1136/hrt.45.1.20.

Abstract

Forty-one children with transposition of the great arteries, ventricular septal defect, and left ventricular outflow tract obstruction underwent a Rastelli operation between 1971 and 1978. A homograft valve preserved in an antibiotic solution and extended with A dacron tube was the conduit of choice. Alternatively, conduits with porcine heterografts or valves constructed from calf pericardium were used. They were positioned to the left of the aorta whenever possible. The intraventricular tunnel from the left ventricle to the aorta was constructed from Dacron velour. There were four early and seven late deaths. The last 13 consecutive patients have survived. Early deaths were related to unfavourable anatomy, conduit compression, and sepsis. Residual ventricular septal defects and postoperative infection were the main factors contributing to the late deaths.

摘要

1971年至1978年间,41例患有大动脉转位、室间隔缺损和左心室流出道梗阻的儿童接受了Rastelli手术。保存在抗生素溶液中并用涤纶管延长的同种异体瓣膜是首选的管道。另外,也使用了猪异种移植物管道或由小牛心包构建的瓣膜。只要有可能,它们就放置在主动脉左侧。从左心室到主动脉的室内隧道由涤纶绒制成。有4例早期死亡和7例晚期死亡。最后连续13例患者存活。早期死亡与解剖结构不佳、管道受压和败血症有关。残余室间隔缺损和术后感染是导致晚期死亡的主要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d40f/482484/4e687899a9f7/brheartj00179-0029-a.jpg

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