Modified intra/extracardiac conduit total cavopulmonary connection for the treatment of complex congenital heart disease
10.7507/1007-4848.201703052
- VernacularTitle:改良心内/心外管道全腔静脉肺动脉连接治疗复杂先天性心脏病
- Author:
HUANG Jianbing
1
;
MEI Ju
1
;
ZHANG Junwen
1
;
ZHANG Yunjiao
1
;
ZHANG Li
1
;
DING Fangbao
1
Author Information
1. Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200092, P.R.China
- Publication Type:Journal Article
- Keywords:
Complex congenital heart disease;
total cavopulmonary connection;
intra/extracardiac conduit
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2018;25(4):303-306
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the surgery experience of modified intra/extracardiac conduit total cavopulmonary connection (TCPC). Methods We retrospectively analyzed clinical data of 47 patients of complex congenital heart disease undergoing intra/extracardiac conduit total cavopulmonary connection in our hospital between January 2008 and December 2015. There were 29 males and 18 females with a median age of 7 years (range 4 to 9 years) and median body weight of 22 kg (range 14 to 38 kg). The heart echocardiography and cardiac imaging confirmed diagnosis suitable for TCPC surgery. Results There was no early death in the whole group. The mean pulmonary arterial pressure was 16 (12–20) mm Hg and the ventilation time was 14 (7–97) h. The main complications were intractable pleural effusion in 7 patients, low cardiac output syndrome in 3 patients, repeated supraventricular tachycardia in 1 patient. All the patients recovered after treatment. At the end of discharge, the percutaneous oxygen saturation was 85%–96% (92.6%±3.3%). The echocardiography showed the conduit pressure was 0–2 mm Hg. Patients were followed up for 1 to 7 years. Three patients were lost. One patient had intestinal nutrition loss, receving repeated pleural effusion, the treatment was ineffective, died after 4 years. Four patients of repeated pleural effusion improved after treatment. One patient repeated attacks supraventricular tachycardia within 1 year, controlled by amiodaronum, already stopped about 28 months. No recurrence occurred. All survivors were in New York Heart Association (NYHA) functional class Ⅰ or Ⅱ, with good activity tolerance. Conclusion The modified intra/extracardiac conduit TCPC combines the advantages of both the lateral tunnel and the extracardiac conduit. The operation is simple, used in the treatment of complex congenital heart disease. The short-term and mid-term results are encouraging.
