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	102例动脉调转术病儿的冠状动脉分型
	胡盛寿 ; 王小殷 ; 刘迎龙 ; 吴清玉 ; 李守军 ; 沈向东 ; 刘盛 ; HU Sheng-shou ; WANG Xiaoqi ; LIU Ying-Long ; Wu Qingyu ; Li Shoujun ; Shen Xiangdong ; Liu Sheng
	2010-06-09 ; 2010-06-09
关键词	大血管错位 心脏外科手术 冠状血管畸形 解剖 Transposition of great vessels Cardiac surgical procedures Coronary vessel anomalies Dissection R726.5
其他题名	Arterial switch operation:coronary artery pattern and surgical treatment(Report of 102 cases)
中文摘要	目的总结动脉调转手术冠状动脉分型及相应的手术方法和结果。方法回顾分析1999年10月至2005年10月102例行动脉调转手术病儿,男73例,女29例。年龄3 d～7岁;体重2.5～20.0kg。主动脉位于肺动脉右前方74例(72.5%),左前11例(10.8%),正前方10例(9.8%),并列关系7例(6.8%)。其中简单大动脉转位55例,复杂大动脉转位29例,Taussing-Bing 畸形18例。采用 Leiden 冠状动脉分型方法,1LCx2R 为冠状动脉正常分布,共69例,其他类型为冠状动脉异常分布,共33例,其中3例冠状动脉壁内走行。冠状动脉吻合主要采用带片开门技术或吊窗技术,病儿均应用 Lecompte 技术。结果死亡15例,手术死亡率14.7%。冠状动脉正常者死亡6例(8.7%,6/69例),冠状动脉异常分布者死亡9例(27.3%,9/33例)。简单大动脉转位死亡5例中3例发生冠状动脉事件,其中2例冠状动脉变异。复杂型大动脉转位死亡6例中4例发生冠状动脉事件,其中3例冠状动脉变异。Taussing-Bing 畸形死亡4例中3例发生冠状动脉事件,均存在冠状动脉变异。结论复杂冠状动脉类型增加手术风险,熟悉冠状动脉分型、提高外科技术和积累经验是降低风险的关键。; Objective To summarize the coronary artery pattem of arterial switch operation(ASO),operative skill and surgical results.Methods Between October 1999 to October 2005,102 patients underwent arterial switch operation.The mean age was(8� 16)months ranged from 3 days to 7 years.The mean body weight was(5.9�2)kg,ranged from 2.5 kg to 20.0 kg.Most com- monly(74/102),the aorta was more or less to the right of the pulmonary artery.In 10 patients,the aorta was directly anterior to the pulmonary artery,and in 11 patients,the aorta was to the left of the pulmonary artery.The great arteries were side by side in 7 pa- tients.We used Leiden classification for coronary artery pattern by operative descriptions.The most prevalent coronary pattern [1LCx2R]was found in 69(67.6%),abnormal coronary artery pattern in 33(32.3%).Intramural course of coronary artery was fotmd In three patients.The Leeampte maneuver was used in all cases.In most patients,the "open trap door" or "bay window" tech- nique for coronary osfia transfer.Results Total mortality rate was 14.7 %(15 eases),6 cases(8.7 %)with normal coronary pattem and 9(27.3%)deaths 33 patients with abnormal coronary pattern.3 cases with coronary event occurred in 5 deaths of simple rIGA, 4 cases with coronary event in 6 deaths of complex TGA and 3 eases with coronary event in 4 deaths of Taussing-Bing anomaly.Con- clusion Complex coronary artery anatomy increases the operative risk.With experience or improving surgical technique,we may get better results.
语种	中文 ; 中文
内容类型	期刊论文
源URL	[http://hdl.handle.net/123456789/59019]
专题	清华大学
推荐引用方式 GB/T 7714	胡盛寿,王小殷,刘迎龙,等. 102例动脉调转术病儿的冠状动脉分型[J],2010, 2010.
APA	胡盛寿.,王小殷.,刘迎龙.,吴清玉.,李守军.,...&Liu Sheng.(2010).102例动脉调转术病儿的冠状动脉分型..
MLA	胡盛寿,et al."102例动脉调转术病儿的冠状动脉分型".(2010).

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