一个半心室治疗的新领域——心脏位置异常的复杂矫正型大动脉转位矫治术_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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杨克明 , 郑帅 , 花中东等

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Keywords：

一个半心室修复; 矫正型大动脉转位; 先天性心脏病; 心脏位置异常

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目的介绍一种治疗心脏位置异常的复杂矫正型大动脉转位（ cTGA）的新方法。方法中国医学科学院阜外心血管病医院 2011年采用“一个半心室修复”治疗心脏位置异常的 cTGA患者 1例，男，5岁 1个月。检索 PubMed、维普医药信息资源系统、万方数据知识服务平台等文献数据库，复习采用“一个半心室修复”治疗 cTGA的相关文献。结果我院 1例患者术后恢复良好，无明显手术相关并发症，术后第 11 d痊愈出院。出院时心脏超声心动图提示：肺静脉 -左心房及下腔静脉转流通畅，双侧上腔静脉 -肺动脉连接通畅，心室 -大动脉连接正常，心室流出道通畅，心室水平分流消失。共检索 3篇文献报道采用“一个半心室修复”策略治疗 cTGA，其中仅有 1篇文献报道了对心脏位置异常的复杂 cTGA采用一个半心室修复，平均随访 59.2个月，一个半心室修复延长了右心室 -肺动脉外管道的使用寿命，减少了肺静脉梗阻和心律失常、改善了心功能。结论对心脏位置异常的复杂 cTGA患者，一个半心室修复是一种安全有效的治疗策略。

Citation： 杨克明,郑帅,花中东等. 一个半心室治疗的新领域——心脏位置异常的复杂矫正型大动脉转位矫治术. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(2): 193-196. doi: Copy

1.	Marianeschi SM, McElhinney DB, Reddy VM. Pulmonary arteriovenous malformations in and out of the setting of congenital heart disease. Ann Thorac Surg, 1998, 66（2）：688-691.
2.	Krowka MJ, Cortese DA. Hepatopulmonary syndrome： an evolving perspective in the era of liver transplantation. Hepatology, 1990, 11（1）：138-142.
3.	Mavroudis C, Backer CL, Kohr LM, et al. Bidirectional Glenn shunt in association with congenital heart repairs： the 1（1/2） ventricular repair. Ann Thorac Surg, 1999, 68（3）：976-981.
4.	Hraska V, Duncan BW, Mayer JE Jr, et al. Long-term outcome of surgically treated patients with corrected transposition of the great arteries. J Thorac Cardiovasc Surg, 2005, 129（1）：182-191.
5.	Termignon JL, Leca F, Vouhé PR, et al. “Classic” repair of congenitally corrected transposition and ventricular septal defect. Ann Thorac Surg, 1996, 62（1）：199-206.
6.	Yagihara T, Kishimoto H, Isobe F, et al. Double switch operation in cardiac anomalies with atrioventricular and ventriculoarterial discordance. J Thorac Cardiovasc Surg, 1994, 107（2）：351-358.
7.	Reddy VM, McElhinney DB, Silverman NH, et al. The double switch procedure for anatomical repair of congenitally corrected transposition of the great arteries in infants and children. Eur Heart J, 1997, 18（9）：1470-1477.
8.	Karl TR, Weintraub RG, Brizard CP, et al. Senning plus arterial switch operation for discordant （congenitally corrected） transposition. Ann Thorac Surg, 1997, 64（2）：495-502.
9.	Malhotra SP, Reddy VM, Qiu M, et al. The hemi-mustard/bidirectional Glenn atrial switch procedure in the double-switch operation for congenitally corrected transposition of the great arteries： rationale and midterm results. J Thorac Cardiovasc Surg, 2011, 141（1）：162-170.
10.	DiBardino DJ, Heinle JS, Fraser CD Jr, et al. The hemi-Mustard, bi-directional Glenn, and Rastelli operations used for correction of congenitally corrected transposition, achieving a “ventricle and a half ” repair. Cardiol Young, 2004, 14（3）：330-332.
11.	张南滨, 汪曾炜, 朱洪玉, 等. 双调转术治疗先天性矫正型大动脉转位疗效分析. 中华胸心血管外科杂志, 2004, 20（6）：366.
12.	Giannico S, Hammad F, Amodeo A, et al. Clinical outcome of 193 extracardiac Fontan patients： the first 15 years.J Am Coll Cardiol, 2006, 47（10）：2065-2073.
13.	Clarkson PM, Neutze JM, Barratt-Boyles BG, et al. Late postoperative hemodynamic results and cineangiocardiographic findings after Mustard atrial baffle repair for transposition of the great arteries. Circulation, 1976, 53（3）:525-532.
14.	Helbing WA, Hansen B, Ottenkamp J, et al. Long-term results of atrial correction for transposition of the great arteries. Comparison of Mustard and Senning operations. J Thorac Cardiovasc Surg, 1994, 108（2）：363-372.
15.	Berman MA, Barash PS, Hellenbrand WE, et al. Late development of severe pulmonary venous obstruction following the Mustard operation. Circulation, 1977, 56（3 Suppl）：Ⅱ91-94.
16.	Flinn CJ, Wolff GS, Dick M 2nd, et al. Cardiac rhythm after the Mustard operation for complete transposition of the great arteries.N Engl J Med, 1984, 310（25）：1635-1638.
17.	Williams WG, Trusler GA, Kirklin JW, et al. Early and late results of a protocol for simple transposition leading to an atrial switch （Mustard） repair. J Thorac Cardiovasc Surg, 1988, 95（4）：717-726.

1. 　Marianeschi SM, McElhinney DB, Reddy VM. Pulmonary arteriovenous malformations in and out of the setting of congenital heart disease. Ann Thorac Surg, 1998, 66（2）：688-691.
2. 　Krowka MJ, Cortese DA. Hepatopulmonary syndrome： an evolving perspective in the era of liver transplantation. Hepatology, 1990, 11（1）：138-142.
3. 　Mavroudis C, Backer CL, Kohr LM, et al. Bidirectional Glenn shunt in association with congenital heart repairs： the 1（1/2） ventricular repair. Ann Thorac Surg, 1999, 68（3）：976-981.
4. 　Hraska V, Duncan BW, Mayer JE Jr, et al. Long-term outcome of surgically treated patients with corrected transposition of the great arteries. J Thorac Cardiovasc Surg, 2005, 129（1）：182-191.
5. 　Termignon JL, Leca F, Vouhé PR, et al. “Classic” repair of congenitally corrected transposition and ventricular septal defect. Ann Thorac Surg, 1996, 62（1）：199-206.
6. 　Yagihara T, Kishimoto H, Isobe F, et al. Double switch operation in cardiac anomalies with atrioventricular and ventriculoarterial discordance. J Thorac Cardiovasc Surg, 1994, 107（2）：351-358.
7. 　Reddy VM, McElhinney DB, Silverman NH, et al. The double switch procedure for anatomical repair of congenitally corrected transposition of the great arteries in infants and children. Eur Heart J, 1997, 18（9）：1470-1477.
8. 　Karl TR, Weintraub RG, Brizard CP, et al. Senning plus arterial switch operation for discordant （congenitally corrected） transposition. Ann Thorac Surg, 1997, 64（2）：495-502.
9. 　Malhotra SP, Reddy VM, Qiu M, et al. The hemi-mustard/bidirectional Glenn atrial switch procedure in the double-switch operation for congenitally corrected transposition of the great arteries： rationale and midterm results. J Thorac Cardiovasc Surg, 2011, 141（1）：162-170.
10. 　DiBardino DJ, Heinle JS, Fraser CD Jr, et al. The hemi-Mustard, bi-directional Glenn, and Rastelli operations used for correction of congenitally corrected transposition, achieving a “ventricle and a half ” repair. Cardiol Young, 2004, 14（3）：330-332.
11. 　张南滨, 汪曾炜, 朱洪玉, 等. 双调转术治疗先天性矫正型大动脉转位疗效分析. 中华胸心血管外科杂志, 2004, 20（6）：366.
12. 　Giannico S, Hammad F, Amodeo A, et al. Clinical outcome of 193 extracardiac Fontan patients： the first 15 years.J Am Coll Cardiol, 2006, 47（10）：2065-2073.
13. 　Clarkson PM, Neutze JM, Barratt-Boyles BG, et al. Late postoperative hemodynamic results and cineangiocardiographic findings after Mustard atrial baffle repair for transposition of the great arteries. Circulation, 1976, 53（3）:525-532.
14. 　Helbing WA, Hansen B, Ottenkamp J, et al. Long-term results of atrial correction for transposition of the great arteries. Comparison of Mustard and Senning operations. J Thorac Cardiovasc Surg, 1994, 108（2）：363-372.
15. 　Berman MA, Barash PS, Hellenbrand WE, et al. Late development of severe pulmonary venous obstruction following the Mustard operation. Circulation, 1977, 56（3 Suppl）：Ⅱ91-94.
16. 　Flinn CJ, Wolff GS, Dick M 2nd, et al. Cardiac rhythm after the Mustard operation for complete transposition of the great arteries.N Engl J Med, 1984, 310（25）：1635-1638.
17. 　Williams WG, Trusler GA, Kirklin JW, et al. Early and late results of a protocol for simple transposition leading to an atrial switch （Mustard） repair. J Thorac Cardiovasc Surg, 1988, 95（4）：717-726.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

一个半心室治疗的新领域——心脏位置异常的复杂矫正型大动脉转位矫治术

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