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find Author "李文雷" 2 results
  • Early- and mid-term outcomes of surgical repair of persistent truncus arteriosus in children

    ObjectiveTo evaluate the early- and mid-term outcomes of surgical repair of persistent truncus arteriosus in children in a single institution of China.MethodsThe clinical data of 27 consecutive patients with persistent truncus arteriosus undergoing surgical repair in Guangzhou Women and Children’s Medical Center from November 2009 to May 2018 were retrospectively reviewed. There were 14 males and 13 females. Median age was 3.0 months (range: 13 days -11 years), of whom 10 (37.0%) were older than 6 months. ResultsThere were three early deaths with a mortality of 11.1%. The main complications included VSD partial repair in 2 patients, complete atrioventricular block in one patient. The mean follow-up time was 24.5±19.3 months (range: 1–76 months). There were three late deaths, and two patients lost follow. Echocardiology showed seven patients of right heart outflow tract obstruction, including three in pulmonary artery trunk, and four of pulmonary artery branches. One patient showed moderate aortic valve regurgitation. None required re-intervention during the follow-up. Survival estimates for the entire cohort following surgery were both 76.1% (95%CI 59.2% to 92.9%) at 1 year and 5 years.ConclusionThe surgical repair of persistent truncus arteriosus (PTA) remains challenges. The early- and mid-term outcomes of surgical repair of persistent truncus arteriosus are acceptable. For older children with severe pulmonary artery hypertension and/or trunk valve regurgitation, the risk of death is still higher. Some children have the higher risk of late right heart obstructive lesions.

    Release date:2019-03-29 01:35 Export PDF Favorites Scan
  • Ross-Konno 手术治疗儿童主动脉瓣及瓣下狭窄的临床疗效

    目的评价 Ross-Konno 手术治疗儿童主动脉瓣及瓣下狭窄的早期临床疗效。方法2018 年 12 月至 2019 年 12 月,共 12 例患儿因主动脉瓣及瓣下狭窄在我科接受手术治疗,其中男 8 例、女 4 例,接受手术时中位年龄 4 岁(11 个月~12 岁)。Ross-Konno 手术 11 例,单纯 Ross 手术 1 例。主动脉瓣重度狭窄 8 例,主动脉瓣关闭不全 2 例,狭窄合并关闭不全 2 例。合并主动脉二瓣化畸形 6 例,瓣下流出道显著狭窄 4 例,合并二尖瓣病变 4 例,合并弓部病变 3 例。手术采用自体肺动脉带瓣管道移植于主动脉瓣位,同期采用 Konno 法扩大左室流出道。采用牛颈静脉或带瓣 Gore-tex 人工血管重建右室流出道,并同期矫治心内合并畸形。所有患者均经多普勒彩色超声心动图定期进行随访评估。结果全组无手术死亡。术后中位随访时间 5.5(1~12)个月,1 例患儿残余左室流出道中度狭窄,其余患儿无显著左室流出道残余梗阻或复发梗阻,无新主动脉瓣显著反流。1 例患儿肺动脉带瓣管道主干中度狭窄,余重建右室流出道血流通畅,无明显瓣膜反流及赘生物形成。结论对于不适合瓣膜成形或置换术的儿童主动脉瓣膜病变,Ross-Konno 手术早期结果满意。

    Release date:2020-04-26 03:44 Export PDF Favorites Scan
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