完全性房室间隔缺损合并法洛四联症外科矫治的单中心临床经验_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

张勇 , 温树生 , 田苗 , 刘晓冰 , 许刚 , 岑坚正 , 崔虎军 , 庄建 ,  陈寄梅

广东省心血管病研究所广东省人民医院心脏大血管外科广东省华南结构性心脏病重点实验室（广州 510100）;

Corresponding author：

陈寄梅, Email: jimei1965@gmail.com

Keywords：

先天性心脏病; 完全性房室间隔缺损; 法洛四联症; 外科

DOI：

10.7507/1007-4848.201811020

Video：

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目的分析单个临床中心完全性房室间隔缺损合并法洛四联症的外科治疗经验。方法回顾性分析广东省人民医院心外科 2008 年 5 月至 2017 年 3 月收治的 21 例经超声心动图诊断为完全性房室间隔缺损合并法洛四联症患者的外科矫治经验，其中男 17 例、女 4 例，年龄 10 个月（1 个月～20 岁），体重 10（2.5～68）kg。分析其临床结局，并随访生存病例，以初步了解其预后。结果住 ICU 时间 4（1～23）d，住院时间 12（6～21）d。死亡 3 例。21 例患者中，双心室矫治 6 例，单心室矫治 15 例。平均随访时间 3 年，5 年生存率 80%。结论完全性房室间隔缺损合并法洛四联症外科解剖矫治困难，多数病例仅可施行单心室矫治手术，部分病例可施行双心室矫治手术，远期预后良好。

Citation： 张勇, 温树生, 田苗, 刘晓冰, 许刚, 岑坚正, 崔虎军, 庄建, 陈寄梅. 完全性房室间隔缺损合并法洛四联症外科矫治的单中心临床经验. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(8): 819-821. doi: 10.7507/1007-4848.201811020 Copy

1.	Cohen MS, Spray TL. Surgical management of unbalanced atrioventricular canal defect. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2005: 135-144.
2.	Liu VJ, Yong MS, d'Udekem Y, et al. Outcomes of atrioventricular valve operation in patients with Fontan circulation. Ann Thorac Surg, 2015, 99(5): 1632-1638.
3.	Jacobs JP, Mayer JE Jr, Pasquali SK, et al. The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2018 update on outcomes and quality. Ann Thorac Surg, 2018, 105(3): 680-689.
4.	Vijarnsorn C, Khoo NS, Tham EB, et al. Increased common atrioventricular valve tenting is a risk factor for progression to severe regurgitation in patients with a single ventricle with unbalanced atrioventricular septal defect. J Thorac Cardiovasc Surg, 2014, 148(6): 2580-2588.
5.	孙国成, 朱海龙, 易定华, 等. 法洛四联症合并完全性房室隔缺损的外科治疗. 中国胸心血管外科临床杂志, 2007, 14(1): 72-73.
6.	崔虎军, 庄建, 陈寄梅, 等. 完全性房室隔缺损外科治疗的早中期结果. 中华外科杂志, 2017, 55(12): 933-937.
7.	胡仁杰, 张海波, 徐志伟, 等. 法洛四联症合并完全性房室间隔缺损的手术治疗. 中华胸心血管外科杂志, 2013, 29(5): 257-260.
8.	严勤, 徐志伟, 刘锦纷, 等. 双心室矫治法洛四联症合并完全性房室间隔缺损的效果. 心肺血管病杂志, 2014, 33(2): 159-162.
9.	Vitanova K, Cleuziou J, Schreiber C, et al. long-term outcome of patients with complete atrioventricular septal defect combined with the tetralogy of Fallot: staged repair is not inferior to primary repair. Ann Thorac Surg, 2017, 103(3): 876-880.
10.	Ong J, Brizard CP, d'Udekem Y, et al. Repair of atrioventricular septal defect associated with tetralogy of Fallot or double-outlet right ventricle: 30 years of experience. Ann Thorac Surg, 2012, 94(1): 172-178.
11.	Prifti E, Bonacchi M, Bernabei M, et al. Repair of complete atrioventricular septal defect with tetralogy of Fallot: our experience and literature review. J Card Surg, 2004, 19(2): 175-183.
12.	邓盛, 刘邕波, 白韬. 44 例完全性房室通道的外科治疗. 局解手术学杂志, 2009, 18(6): 385-386.
13.	刘迎龙, 吴永涛, 许耀强, 等. 完全性心内膜垫缺损的外科治疗经验. 心肺血管病杂志, 2013, 32(6): 671-674.
14.	Ginde S, Lam J, Hill GD, et al. Long-term outcomes after surgical repair of complete atrioventricular septal defect. J Thorac Cardiovasc Surg, 2015, 150(2): 369-374.
15.	Gupta U, Polimenakos AC, El-Zein C, et al. Tetralogy of Fallot with atrioventricular septal defect: surgical strategies for repair and midterm outcome of pulmonary valve-sparing approach. Pediatr Cardiol, 2013, 34(4): 861-871.
16.	Raju V, Burkhart HM, Rigelman Hedberg N, et al. Surgical strategy for atrioventricular septal defect and tetralogy of Fallot or double-outlet right ventricle. Ann Thorac Surg, 2013, 95(6): 2079-2084.

1. Cohen MS, Spray TL. Surgical management of unbalanced atrioventricular canal defect. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2005: 135-144.
2. Liu VJ, Yong MS, d'Udekem Y, et al. Outcomes of atrioventricular valve operation in patients with Fontan circulation. Ann Thorac Surg, 2015, 99(5): 1632-1638.
3. Jacobs JP, Mayer JE Jr, Pasquali SK, et al. The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2018 update on outcomes and quality. Ann Thorac Surg, 2018, 105(3): 680-689.
4. Vijarnsorn C, Khoo NS, Tham EB, et al. Increased common atrioventricular valve tenting is a risk factor for progression to severe regurgitation in patients with a single ventricle with unbalanced atrioventricular septal defect. J Thorac Cardiovasc Surg, 2014, 148(6): 2580-2588.
5. 孙国成, 朱海龙, 易定华, 等. 法洛四联症合并完全性房室隔缺损的外科治疗. 中国胸心血管外科临床杂志, 2007, 14(1): 72-73.
6. 崔虎军, 庄建, 陈寄梅, 等. 完全性房室隔缺损外科治疗的早中期结果. 中华外科杂志, 2017, 55(12): 933-937.
7. 胡仁杰, 张海波, 徐志伟, 等. 法洛四联症合并完全性房室间隔缺损的手术治疗. 中华胸心血管外科杂志, 2013, 29(5): 257-260.
8. 严勤, 徐志伟, 刘锦纷, 等. 双心室矫治法洛四联症合并完全性房室间隔缺损的效果. 心肺血管病杂志, 2014, 33(2): 159-162.
9. Vitanova K, Cleuziou J, Schreiber C, et al. long-term outcome of patients with complete atrioventricular septal defect combined with the tetralogy of Fallot: staged repair is not inferior to primary repair. Ann Thorac Surg, 2017, 103(3): 876-880.
10. Ong J, Brizard CP, d'Udekem Y, et al. Repair of atrioventricular septal defect associated with tetralogy of Fallot or double-outlet right ventricle: 30 years of experience. Ann Thorac Surg, 2012, 94(1): 172-178.
11. Prifti E, Bonacchi M, Bernabei M, et al. Repair of complete atrioventricular septal defect with tetralogy of Fallot: our experience and literature review. J Card Surg, 2004, 19(2): 175-183.
12. 邓盛, 刘邕波, 白韬. 44 例完全性房室通道的外科治疗. 局解手术学杂志, 2009, 18(6): 385-386.
13. 刘迎龙, 吴永涛, 许耀强, 等. 完全性心内膜垫缺损的外科治疗经验. 心肺血管病杂志, 2013, 32(6): 671-674.
14. Ginde S, Lam J, Hill GD, et al. Long-term outcomes after surgical repair of complete atrioventricular septal defect. J Thorac Cardiovasc Surg, 2015, 150(2): 369-374.
15. Gupta U, Polimenakos AC, El-Zein C, et al. Tetralogy of Fallot with atrioventricular septal defect: surgical strategies for repair and midterm outcome of pulmonary valve-sparing approach. Pediatr Cardiol, 2013, 34(4): 861-871.
16. Raju V, Burkhart HM, Rigelman Hedberg N, et al. Surgical strategy for atrioventricular septal defect and tetralogy of Fallot or double-outlet right ventricle. Ann Thorac Surg, 2013, 95(6): 2079-2084.

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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

完全性房室间隔缺损合并法洛四联症外科矫治的单中心临床经验

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