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Title:: Analysis of surgical treatment of complex adult congenital heart disease

作者:: 张荣媛¹; 张燕搏¹; 杨克明²; 黄海波¹; 史晨¹; 蒙沿海¹; 常硕¹; （中国医学科学院阜外心血管病医院:1.ICU，2.外科北京 100037）

Author(s):: ZHANG Rong-yuan¹; ZHANG Yan-bo¹; YANG Ke-ming²; HUANG Hai-bo¹; SHI Chen¹; MENG Yan-hai¹; CHANG Shuo¹; (1.Intensive Care Unit；
2.Department of Surgery, Fuwai Angiocardiopathy Hospital, Chinese Academy of Medical Sciences, Beijing 100037, China)

关键词:: 心脏病; 先天性; 成人; 复杂畸形; 外科手术治疗

Keywords:: adult congenital heart disease; complicated deformity; surgical treatment

分类号:: R541.1

DOI:: -

文献标识码:: A

摘要:: 目的对167例复杂畸形成人先天性心脏病（ACHD）病例的外科治疗结果进行总结分析。方法对阜外医院2012年1月~ 2015年2月共167例复杂畸形ACHD患者的病种、手术术式及术后早期结果进行总结和分析。结果完成矫治手术135例，姑息手术30例，二次手术心包开窗术2例，发病最多的前3位病种依次为法洛氏四联症（TOF），部分型肺静脉异位引流（PAPVC）和完全型心内膜垫缺损TECD。术后死亡2例，死亡率1.19%。术后并发症36例，发生率21.6%。术后患者呼吸机辅助平均时间（26±13）h。ICU治疗时间（3.2±1.6）d。结论虽然复杂畸形ACHD手术存在一定难度，但手术术式及围术期处理得当，仍可获得满意的效果。

Abstract:: AIM To analyze the results of the surgical treatment in 167 cases of adult congenital heart disease (ACHD) with complex malformation. METHODS A total of 167 surgically treated patients with adult congenital heart disease (ACHD) with complex malformation from January 2012 to February 2015 in Fuwai Hospital were included in this study. Clinical data, type of ACHD, surgical technique, and preoperative results of these patients were collected and analyzed. RESULTS Of the 167 cases, 135 underwent correction operation, 30 underwent palliative operation and two underwent two pericardial fenestration procedures. Tetralogy of Fallot (TOF) had the highest incidence (20.3%) followed by partial anomalous pulmonary venous connection (PAPVC) (13.8%) and complete type endocardial cushion defect (TECD) (10.8%). After operation, two patients died with a mortality rate of 1.19%. Thirty-six patients had postoperative complications with an incidence of 21.6%. The average mechanical ventilation time was( 26±13) h and the average ICU time was (3.2±1.6) day. CONCLUSION Adult congenital heart disease has a long personal disease history, which results in obvious pathological and physiological changes. If ACHD is treated with proper surgical technique, satisfactory results can be achieved.

参考文献/References

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复杂畸形成人先天性心脏病的外科治疗分析

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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