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目的总结32例婴幼儿主动脉缩窄的外科治疗经验。方法手术治疗婴幼儿主动脉缩窄(CoA)32例。单纯主动脉缩窄7例,合并动脉导管未闭(PDA)17例,合并心内畸形的25例,合并主动脉弓发育不良1例。采用正中胸骨切口或左侧切口,手术方法包括缩窄段切除主动脉端端或端侧吻合24例;纵行切开缩窄段,心包片加宽成形7例;1例应用锁骨下动脉片翻转法。结果死亡3例,29例患儿顺利出院,上下肢压力差消失,其中25例随诊3个月～3年,2例出现主动脉轻度狭窄。无其他并发症。结论婴幼儿主动脉缩窄的外科治疗可获得良好的近中期疗效,合并心内畸形的患儿大部分可采取正中切口一期手术。
Objective To summarize the surgical experience of 32 cases of aortic constriction in infants and young children. Methods Surgical treatment of infantile aortic constriction (CoA) in 32 cases. Seven cases of simple aortic constriction, 17 cases of combined patent ductus arteriosus (PDA), 25 cases of intracardiac deformity and 1 case of aortic arch dysplasia. Using the median sternotomy or left incision, surgical methods include aortic end resection or end to end anastomosis in 24 cases; longitudinal incision and narrowing, pericardium widening in 7 cases; 1 case of subclavian artery Flip method. Results Three patients died and 29 patients were discharged smoothly. The pressure difference between upper and lower extremities disappeared. Twenty-five patients were followed up for 3 months to 3 years. Two patients had mild stenosis. No other complications. Conclusion Surgical treatment of aortic stenosis in infants and young children can achieve good near and mid-term curative effect. The majority of children with intra-cardiac malformations can take a median incision surgery.