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目的总结动脉调转术(ASO)治疗心室大动脉连接异常的先天性心脏病(先心病)手术疗效。方法2000年1月至2004年8月,60例病儿实施ASO,早年(2000.1～2003.5)42例,近期(2003.6～2004.8)18例;其中完全性大动脉转位(TGA)49例、TaussigBing畸形7例、矫正性大动脉转位(ccTGA)4例;年龄1～6个月15例、7～12个月14例、1～3岁6例、>3岁6例,其中>6月龄的TGA/VSD或TGA/PDA18例。行大动脉调转术,同期矫治合并畸形;ccTGA病儿先行心房转流术,后行ASO。结果全组手术死亡10例(16.7%),其中早年9例(21.4%)、近期1例(5.6%),死亡率明显下降(P<0.05)。生存病儿随访0.5～56.0个月,心功能恢复良好,无死亡及并发症。结论ASO应用于TGA、TaussigBing畸形以及ccTGA能取得良好的手术结果。针对国内TGA/VSD或TGA/PDA病儿就诊较晚、年龄较大,肺动脉压力较高等特点,如心导管检查显示肺小动脉阻力不高,ASO仍可获得满意的疗效。
Objective To summarize the effect of ASO on the treatment of congenital heart disease (CHD) with abnormal connection of ventricular aorta. Methods From January 2000 to August 2004, 60 children were enrolled in ASO. Forty-two patients were diagnosed as early (2000.1 ~ 2003.5) and 18 as patients (2003.6 ~ 2004.8). Among them, 49 cases had complete aortic transposition (TGA), TaussigBing deformity (N = 7) and 4 cases of ccTGA. There were 15 cases of 1-6 months, 14 cases of 7-12 months, 6 cases of 1-3 years and 6 cases of> 3 years old, of which> 6 months TGA / VSD or TGA / PDA18 cases. Aortic surgery, synchronous correction of deformity; ccTGA sick children first atrium bypass, ASO. Results The total number of surgical deaths was 10 (16.7%), of which 9 cases (21.4%) in early years and 1 case (5.6%) in recent years, the mortality decreased significantly (P <0.05). Survival sick children were followed up for 0.5 ~ 56.0 months, heart function recovered well, no death and complications. Conclusion The application of ASO in TGA, TaussigBing deformity and ccTGA can achieve good surgical results. For domestic TGA / VSD or TGA / PDA sick children later treatment, older, higher pulmonary artery pressure characteristics, such as cardiac catheterization showed pulmonary arteriole resistance is not high, ASO can still get satisfactory results.