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目的介绍一种改良REV手术治疗合并室间隔缺损(V SD)、肺动脉瓣狭窄(PS)的复杂型大动脉转位或右心室双出口(DORV)。方法2005年9月~2006年2月我院收治3例复杂型先天性心脏病患者,在经典REV手术的基础上,我们改良了REV手术,保留了肺动脉瓣和瓣环进行手术治疗。结果2例痊愈,1例同时用体外膜式氧合器(ECM O)进行抢救后死亡。痊愈患者分别随访4个月和1个月,超声心动图检查提示肺动脉瓣跨瓣压差分别为15mmHg和5mmHg,结果满意。结论保留肺动脉瓣的改良REV手术对治疗合并V SD、PS的复杂大动脉转位是一种较为理想的手术方法。
Objective To introduce a modified REV procedure for the treatment of complex aortic transposition or double ventricle extubation (DORV) with ventricular septal defect (V SD) and pulmonary stenosis (PS). Methods From September 2005 to February 2006, 3 patients with complicated congenital heart disease were treated in our hospital. Based on the classic REV surgery, we modified the REV surgery and retained the pulmonary valve and valve annulus for surgical treatment. Results Two patients recovered and one patient died after rescue by external membrane oxygenator (ECM O). The cured patients were followed up for 4 months and 1 month, respectively. Echocardiography showed that the pulmonary valve pressure translocations were 15mmHg and 5mmHg, respectively. The results were satisfactory. Conclusions Modified REV with preservation of the pulmonary valve is an ideal surgical approach for the treatment of complex aortic transposition with V SD and PS.