Neonatal truncus arteriosus repair: surgical techniques and clinical management.
Neonatal truncus arteriosus repair: surgical techniques and clinical management.
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DOI：
10.1053/pcsu.2002.31497
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发表时间：
2002-01-01
期刊：
影响因子：
--
通讯作者：
Hanley, Frank L
中科院分区：
文献类型：
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作者：
Rodefeld, Mark D;Hanley, Frank L
动脉干现在在新生儿期得到了理想的修复，发病率和死亡率较低。已发表的报告记录死亡率在 4% 至 5% 范围内，平均修复年龄低至 11 天。早期修复改善预后的生理基础是避免肺过度循环和心力衰竭的破坏性后遗症。数据显示，接受早期修复的婴儿的基线平均肺动脉压较低。在存在躯干瓣膜功能障碍的情况下，积极的躯干瓣膜修复与置换、针对患者解剖结构的右心室流出道重建技术以及使用局部灌注技术修复相关主动脉弓中断也取得了改善的手术结果。此外，提高对冠状动脉开口位置、数量、起飞角度和通畅程度异常的认识，可以避免无意中对动脉造成的伤害以及相关的心肌损伤。
Truncus arteriosus is now ideally repaired in the neonatal period with low morbidity and mortality. Published reports have documented mortality rates in the range of 4% to 5% with mean age at repair as low as 11 days. The physiologic basis for improved outcomes with earlier repair is the avoidance of damaging sequelae of pulmonary overcirculation and heart failure. Data show that baseline mean pulmonary artery pressure is lower in infants undergoing earlier repair. Improved operative outcomes also have been achieved with aggressive truncal valve repair versus replacement in the presence of truncal valve dysfunction, right ventricular outflow tract reconstructive techniques that are patient anatomy-specific, and use of regional perfusion techniques for repair of associated interrupted aortic arch. In addition, a heightened awareness of anomalies of coronary artery ostial location, number, angle of takeoff, and degree of patency can result in avoidance of inadvertent injury to the artery and associated myocardial insult.