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[大动脉转位矫正术后心脏畸形的矫正。18例采用心脏直视技术手术的病例系列]

[Correction of cardiac malformations after corrected transposition of the great vessels. A series of 18 cases operated on by an open heart technique].

作者信息

Hazan E, Bex J P, Marchand M, Lecompte Y, Menu P, Lemoine G, Jarreau M M, Neveux J Y

出版信息

Arch Mal Coeur Vaiss. 1978 Jun;71(6):657-64.

PMID:99107
Abstract

Recent progress in the surgical treatment of malformations after transposition has been dealt with has been made in three directions: 1. By knowledge of the position of the conducting pathways in relation to ventricular septal defects, so that total atrioventricular block, the first complication of this type of surgery, may be avoided; 2. By appreciation of the proximity of the conductive pathways to the elements contributing to pulmonary stenosis, which may contra-indicate direct removal of such stenosis. In such a case, a valved tube must be placed between the sub-pulmonary ventricle and the pulmonary artery; 3. By appreciating the frequency, the difficulty in diagnosis and the grave consequences of failing to recognise lesions of the atrioventricular valves, with the result that their systematic investigation should form part of the operative technique.

摘要

大动脉转位术后畸形矫治的外科治疗近期进展体现在三个方面

  1. 了解传导通路与室间隔缺损的位置关系,从而避免这类手术的首个并发症——完全性房室传导阻滞;2. 认识到传导通路与导致肺动脉狭窄的结构毗邻,这可能成为直接解除此类狭窄的禁忌证。在这种情况下,必须在肺动脉下心室与肺动脉之间置入带瓣管道;3. 认识到房室瓣病变的发生率、诊断困难程度以及未能识别这些病变的严重后果,因此,对房室瓣进行系统检查应成为手术操作技术的一部分。

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