Objective Evaluating a new continuity between the right ventricle and the pulmonary artery for repair of persistent truncus arteriosus(PTA).Methods Between January 2000 and December 2012,we performed operation of 53 children with without a conduit:sleeve and direct right ventricle-pulmonary artery anastomosis [age,40 day to 2.3 years; median age,(0.9 ± 0.5) years] in 86 cases of PTA.The other 33 cases were performed with valved conduit.we used different methods to form the posterior floor of the new pulmonary arterial trunk.The edge of the floor was attached directly to the superior margin of an oblique incision made in the left-anterior wall of the right ventricle.A Gortex monocusp was attached to the lower half margin of the right ventricular incision in 26 cases.Results There were high pulmonary hypertension (PH) in 6 cases with the treatment of anti-PH.There were 2 death postoperatively because of pulmonary hypertension and right heart disfunction.The other patients were discharged from hospital.Cardiac ultrasound at hospital discharge showed pulmonary regurgitation that was trivial in three cases,mild in twentyseven cases,and moderate in twentyone case.During follow-up(36-60 months,median 54 months),there were no death.Conclusion This simple modification for surgical correction of persistent truncus arteriosus may be an effective alternative that overcomes conduit-related problems from the mid-followup period.%目的 评估自体组织重建小儿永存动脉干的右心室流出道方法的临床效果.方法 回顾2000年1月至2012年12月86例PTA患儿资料,53例用自体组织重建小儿永存动脉干的右心室流出道,其余33例用带瓣管道或Gortex管道重建右心室流出道.53例用自体组织重建右心室流出道患儿年龄生后40天～2.3岁,平均(0.9±0.5)岁;体质量3.5～11.0 kg,平均(6.3±2.1)kg.术中用不同方法将切下的肺动脉总干下拉至右心室流出道切口上缘作吻合,26例患儿加单瓣补片,重建右心室流出道.结果 术后死亡2例,死因均为术后肺高压危象,右心功能衰竭.术后早期出现严重肺动脉高压6例,均予靶向肺动脉扩张剂治疗.余患儿均顺利恢复出院.出院时的心脏超声显示肺动脉瓣反流,3例轻微,27例轻度,21例中度.术后36例随访36～60个月,平均54个月,无死亡.结论 自体组织重建小儿永存动脉干的右心室流出道简单、有效,可以避免使用管道所带来的相关问题,减少了再次干预的可能.
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