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首页> 外文期刊>Journal of cardiac surgery. >Outcome of primary repair of infracardiac total anomalous pulmonary venous connection using a right-sided approach to the left atrium.
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Outcome of primary repair of infracardiac total anomalous pulmonary venous connection using a right-sided approach to the left atrium.

机译：使用左侧心房的右侧入路初步修复心包膜下全反常肺静脉连接的结果。

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OBJECTIVE: Pulmonary venous obstruction (PVO), the major postoperative complication in patients with infracardiac total anomalous venous connection (TAPVC), compromises the surgical outcomes of TAPVC repair. Here, we report our experience using a right-sided approach to the left atrium to repair this anomaly variant. METHOD: Eleven patients with infracardiac TAPVC underwent this surgical modification from September 2005 to December 2009. After a medium sternotomy, bicaval venous cannulation was performed for cardiopulmonary bypass (CPB). By adequate exposure of the surgical field, incision of the left atrium was located and anastomosed to the corresponding incision in the pulmonary venous confluence through the right side. Medical records consisting of preoperative and postoperative data were retrospectively reviewed to analyze the efficiency of this strategy. RESULTS: Total correction was achieved in all 11 patients and there were no operative deaths. Postoperative low cardiac output persisted in six patients (54.5%), including five patients with preoperative PVO. No late deaths were noted in a mean follow-up of 26.7 months (range, 1 to 51 months). Both residual atrial shunt and severe anastomotic obstruction were excluded by transthoracic echocardiography. Moderate residual obstruction was confirmed in one patient. At the end of the follow-up, all patients had normal biventricular function and were in New York Heart Association (NYHA) Functional Class I. CONCLUSION: The right-sided approach for repair of infracardiac TAPVC contributes to produce favorable outcomes. This modified technique is useful for enhancing exposure during surgical repair and providing adequate patent anastomosis.
机译：目的：肺静脉阻塞（PVO）是心内膜下全反常静脉连接（TAPVC）患者的主要术后并发症，影响了TAPVC修复的手术效果。在这里，我们报告对左侧心房采用右侧入路修复这种异常变异的经验。方法：2005年9月至2009年12月，对11例心包膜下TAPVC患者进行了外科手术。经过中等胸骨切开术后，进行了双盲静脉插管以进行体外循环（CPB）。通过充分暴露手术区域，找到左心房切口，并通过右侧与肺静脉汇合处的相应切口吻合。回顾性分析由术前和术后数据组成的病历，以分析该策略的有效性。结果：全部11例患者均获得完全矫正，无手术死亡。术后低心输出量持续在6例患者中（54.5％），其中包括5例术前PVO患者。平均随访26.7个月（范围为1到51个月），未发现晚期死亡。经胸超声心动图排除了残留的心房分流和严重的吻合口阻塞。一名患者中度残留梗阻。随访结束时，所有患者的双心室功能均正常，并且属于纽约心脏协会（NYHA）功能I级。结论：右侧方法可修复心内TAPVC，可产生良好的疗效。这种改进的技术可用于在手术修复过程中增加暴露并提供足够的专利吻合。

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