Release date: 2007-10-18
Phase II Fontan treatment of complicated congenital heart disease in children with TCPC can relax the indications for complicated congenital heart disease and increase the success rate of surgery. The application of staging TCPC outside the center pipeline has many advantages. Congenital heart disease is a malformation caused by a defective or partially developed pause in the mother's heart.
A study was published in the second issue of the Chinese Journal of Thoracic and Cardiovascular Surgery in February. The investigators performed Phase II Fontan in 28 patients with complicated intracardiac malformations. The age ranged from 3.0 to 16.5 years, with an average of (7.3 ± 3.8) years; body weight of 13.5 to 61.0 kg, with an average of (21.0 ± 5.5) kg. Mainly for the absence of spleen syndrome, multiple splenic syndrome, tricuspid atresia (TA) and right ventricular double outlet (DORV) with inconsistent atrioventricular connection. In the first phase, unilateral Glenn, bilateral Glenn, and semi-Fontan were performed. The interval between the two operations was 0.8 to 7.3 years, with an average of (3.9 ± 2.8) years, of which 5 patients underwent pulmonary artery shunt before Glenn surgery. Two-dimensional Doppler ultrasonography was performed before operation, and 23 patients underwent cardiac catheterization and cardiovascular angiography. Four different methods of connection were used to introduce blood from the inferior vena cava into the right pulmonary artery to complete the second-stage total pulmonary vascular connection (TCPC).
Zheng Jinghao, a researcher from the Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, showed that 4 patients died after surgery (14.2%). Although comprehensive measures were taken to reduce pulmonary vascular resistance and increase blood flow to the heart, there were still 12 cases of low cardiac output syndrome after operation, including 8 cases of peritoneal dialysis with no renal function due to impaired renal function. Two patients had thrombosis in the right atrium and vena cava, and they were improved after re-thoracic surgery. The arterial oxygen saturation of the inhaled air is between 0.89 and 0.95. The outpatients were followed up for 3 months to 2 years without death. There are no complications such as chronic exudation and protein loss intestinal disease. Therefore, it can be seen that staging TCPC can relax the indications for complicated congenital heart disease and increase the success rate of surgery. The application of staging TCPC outside the center pipeline has many advantages.
——Midi Medical Network
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