Objective To improve the operative effects of patients who had tetralogy of Fallot with aortopulmonary collateral arteries (TOF-APCAs) and evaluate the clinical effects of staging and onestop hybrid approach for TOFAPCAs. Methods From January 2003 to December 2007, thirty patients with TOF-APCAs had undergone combined therapy of APCAs embolization and complete surgical repair. Fifteen patients had APCAs embolization therapy before or after TOF radical operation(staging hybrid group ); Fifteen had onestop hybrid treatment(onestop hybrid group). Results Angiography revealed that there were 19 APCAs in staging hybrid group, and of which 15(78%) were embolized successfully. Five cases had complications and one died from respiratory circulating failure. The rest all recovered and discharged. And 22 APCAs were found in one-stop hybrid group, eighteen (82%) of them were embolized successfully. Only one case had pulmonary effusion. The time of hospitalization(median 37 d vs. 22 d, P=0.011),ICU staying(median 7.0 d vs. 4.7 d,P=0.029)and endotracheal intubation(median 131 h vs. 19 h,P=0.009) was obviously longer, and the hospitalization expenses(median 64 101 [CM(159mm]yuan vs. 48 021 yuan, P=0.033)were obviously higher in staging hybrid group than that in one-stop hybrid group.And there was no statistical significance in cardiopulmonary bypass time(P=0.126) and aortic clamping time(P=0.174) between two groups. Conclusion In comparison with traditional staging hybrid approach, one-stop hybrid approach can simplify the operative process for patients who have TOFAPCAs, improve the operative successful rate and cut down expenses.
Citation: ZHENG Zhe,LI Shoujun,HU Shengshou,et al .. Staging and OneStop Hybrid Approach for Surgical Treatment of Tetralogy of Fallot with Aortopulmonary Collateral Artery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2009, 16(4): 250-253. doi: Copy