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目的 研究同种带瓣主、肺动脉移植应用于复杂性先天性心脏病矫治的疗效。方法 制备同种带瓣管道 89根 (主动脉 5 5根、肺动脉 3 4根 ) ,临床应用 3 1例 ,其中主、肺动脉单瓣作右室流出道跨瓣补片术 14例 ,Rastelli手术 11例 ,右心室 -肺动脉连接 (RV -PA) 3例 ,肺动脉瓣置换1例 ,Ross手术 1例 ,改良Fantan手术 1例。结果 主、肺动脉单瓣作右室流出道跨瓣补片组 14例 ,1例术后 3d死于右心功能不全 ,存活 13例 ,随访 ( 4 3± 3 .2 )个月 ,超声心动图检查显示移植后瓣膜启闭功能良好 ,无增厚及粘连。复杂性先天心脏病矫治组 17例 ,死亡 7例 ,存活 10例 ,随访( 3 4.3± 6.3 9)个月 ,管道血流通过顺畅 ,管壁无变薄、钙化。结论 ①同种带瓣管道具有管壁弹性好 ,易于缝合 ,术后排斥反应少等优点 ,可广泛应用于复杂性先天性心脏病矫治术 ,左、右室流出道的重建 ;②同种带瓣管道补片既能加宽右室流出道 ,且有良好抗返流作用 ,有利于术后患儿心功能恢复 ,使部分复杂的病例能够一次手术根治
Objective To study the curative effect of allograft primary and pulmonary artery grafts in the treatment of complicated congenital heart disease. Methods A total of 89 valves of the same type (valved aorta and 34 pulmonary arteries) were prepared. Thirty-one cases were clinically applied. Among them, 14 cases were treated with transpedular flap of the right and left ventricle of the main and pulmonary arteries, Rastelli operation 11 3 cases of right ventricular-pulmonary artery connection (RV-PA), 1 case of pulmonary valve replacement, 1 case of Ross operation and 1 case of modified Fantan operation. Results Primary and pulmonary valves were used in 14 patients with right ventricular outflow tract transvalvular patch. One patient died of right ventricular dysfunction 3d after operation, and 13 patients were followed up (4.3 ± 3.2) months. Echocardiography Examination showed that valve opening and closing function after transplantation is good, no thickening and adhesions. Seventeen patients with congenital heart disease complicated by congenital heart disease were treated, including 7 deaths and 10 survivals. The follow-up was (4.3 ± 6.39) months. The blood flow was smooth and the walls were thin and calcified. Conclusion ① The same kind of valved tubing has the advantages of good wall elasticity, easy suture, less rejection after operation, etc. It can be widely used in the reconstruction of complex congenital heart disease, left and right ventricular outflow tract; Valvular patch can both widen the right ventricular outflow tract, and has good anti-reflux, is conducive to the recovery of cardiac function in children, so that some cases of complicated cases of radical surgery