完全性房室間隔缺損合并法洛四聯癥外科矯治的單中心臨床經驗_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

張勇 , 溫樹生 , 田苗 , 劉曉冰 , 許剛 , 岑堅正 , 崔虎軍 , 莊建 ,  陳寄梅

廣東省心血管病研究所廣東省人民醫院心臟大血管外科廣東省華南結構性心臟病重點實驗室（廣州 ?510100）;

Corresponding?author：

陳寄梅, Email: jimei1965@gmail.com

Keywords：

先天性心臟病; 完全性房室間隔缺損; 法洛四聯癥; 外科

DOI：

10.7507/1007-4848.201811020

Video：

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目的分析單個臨床中心完全性房室間隔缺損合并法洛四聯癥的外科治療經驗。方法回顧性分析廣東省人民醫院心外科 2008 年 5 月至 2017 年 3 月收治的 21 例經超聲心動圖診斷為完全性房室間隔缺損合并法洛四聯癥患者的外科矯治經驗，其中男 17 例、女 4 例，年齡 10 個月（1 個月～20 歲），體重 10（2.5～68）kg。分析其臨床結局，并隨訪生存病例，以初步了解其預后。結果住 ICU 時間 4（1～23）d，住院時間 12（6～21）d。死亡 3 例。21 例患者中，雙心室矯治 6 例，單心室矯治 15 例。平均隨訪時間 3 年，5 年生存率 80%。結論完全性房室間隔缺損合并法洛四聯癥外科解剖矯治困難，多數病例僅可施行單心室矯治手術，部分病例可施行雙心室矯治手術，遠期預后良好。

Citation： 張勇, 溫樹生, 田苗, 劉曉冰, 許剛, 岑堅正, 崔虎軍, 莊建, 陳寄梅. 完全性房室間隔缺損合并法洛四聯癥外科矯治的單中心臨床經驗. 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.	孫國成, 朱海龍, 易定華, 等. 法洛四聯癥合并完全性房室隔缺損的外科治療. 中國胸心血管外科臨床雜志, 2007, 14(1): 72-73.
6.	崔虎軍, 莊建, 陳寄梅, 等. 完全性房室隔缺損外科治療的早中期結果. 中華外科雜志, 2017, 55(12): 933-937.
7.	胡仁杰, 張海波, 徐志偉, 等. 法洛四聯癥合并完全性房室間隔缺損的手術治療. 中華胸心血管外科雜志, 2013, 29(5): 257-260.
8.	嚴勤, 徐志偉, 劉錦紛, 等. 雙心室矯治法洛四聯癥合并完全性房室間隔缺損的效果. 心肺血管病雜志, 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.	鄧盛, 劉邕波, 白韜. 44 例完全性房室通道的外科治療. 局解手術學雜志, 2009, 18(6): 385-386.
13.	劉迎龍, 吳永濤, 許耀強, 等. 完全性心內膜墊缺損的外科治療經驗. 心肺血管病雜志, 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. 孫國成, 朱海龍, 易定華, 等. 法洛四聯癥合并完全性房室隔缺損的外科治療. 中國胸心血管外科臨床雜志, 2007, 14(1): 72-73.
6. 崔虎軍, 莊建, 陳寄梅, 等. 完全性房室隔缺損外科治療的早中期結果. 中華外科雜志, 2017, 55(12): 933-937.
7. 胡仁杰, 張海波, 徐志偉, 等. 法洛四聯癥合并完全性房室間隔缺損的手術治療. 中華胸心血管外科雜志, 2013, 29(5): 257-260.
8. 嚴勤, 徐志偉, 劉錦紛, 等. 雙心室矯治法洛四聯癥合并完全性房室間隔缺損的效果. 心肺血管病雜志, 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. 鄧盛, 劉邕波, 白韜. 44 例完全性房室通道的外科治療. 局解手術學雜志, 2009, 18(6): 385-386.
13. 劉迎龍, 吳永濤, 許耀強, 等. 完全性心內膜墊缺損的外科治療經驗. 心肺血管病雜志, 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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完全性房室間隔缺損合并法洛四聯癥外科矯治的單中心臨床經驗

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