成人法洛四联症的外科治疗

目的总结成人法洛四联症的外科治疗经验。方法自1999年6月至2009年6月共收治了161例14周岁以上的法洛四联症患者,均在全身麻醉低温体外循环下进行了外科手术治疗。其中153例行法洛四联症根治术,8例行姑息手术。结果全组死亡4例,死亡率2.48%。死于术后低心排综合征2例,术后灌注肺1例,急性肾功能衰竭1例。2次气管插管13例（8.07%）,2例术后复查心脏彩超发现室缺残余瘘。无再次开胸止血。随访139例,6~93个月,无远期死亡。结论成人法洛四联症病情复杂,外科手术治疗并发症发生率偏高,但注意在术前改善症状,术中满意矫治心脏畸形和术后积极防治并发症,远期疗效良好。

Surgical Treatment of Tetralogy of Fallot

Objective Objective To summarize the experience with surgical treatment of adult tetralogy of Fallot.Methods Between June 1999 and June 2009,161 patients（age over 14 years）with tetralogy of Fallot underwent cardiac surgery with hypothermic cardiopulmonary bypass and general anesthesia.Among the 161 patients,153 received radical correction of tetralogy of Fallot,and 8 received palliative surgery.Results There were 4 deaths in these patients,and the mortality rate was 2.48%.Two deaths was caused by low cardiac output,1 by pulmonary edema,and 1 by acute renal failure.The secondary tracheal intubation was performed in 13 patients（8.07%）,and residual fistula was found in 2 patients by postoperative echocardiography.No re-thoracotomy for bleeding was performed.A total of 139 patients were followed-up for 6 to 93 months,and no late death occurred.Conclusion Adult tetralogy of Fallot is a complex disease and is associated with high surgical risk for complications.A excellent long-term efficacy can be obtained by improving preoperative symptoms,satisfactorily correcting heart malformations during operation,and preventing and treating postoperative complications.