先心病心脏不停跳下心内直视手术(附555例报告)

摘要

Objective:To introduce the experience of open-hear t operation of congenital heart disease in 555 cases on beating heart.Method:The operations were done under mild hypothermi c cardiopulmonary bypass .Cardiopulmonary bypass were initiated by cannulation of the aorta,and superior and inferior venae cavae,Only snailed the cava tapes without cross-clampping th e aorta.The perfusion rate was kept blood pressure at 60 mmHg and the body temp erature was around 32℃.The technique of repair the intracardiac malformation un der beating heart was just as same as under aorta cross-clamping.Result:There were eleven patients died(mortality rate 2.0%).Th e others were cured and followed-up for 1～13 months.The recovery were good.Conclusion:Our results shows that the technique i s a new good way for myocardial protection.It can reduce the complicationrate,si mp lify the operative procedure and shorten the mean cardiopulmonary bypass time.%目的：介绍浅低温体外循环心脏不停跳心内直视手 术治疗先天性心脏病心内畸形的应用体会。方法：555例先心病患者 采用该手术，常规建立体外循环，置左心房引流管，降温至32±1℃并维持，仅阻断上下腔 静脉，不阻断主动脉，维持灌注压在60 mmHg左右，心脏跳动下施行畸形矫正，方法同停跳 手术。结果：死亡11例(死亡率2.0%)，其余均痊愈出院，随访1～13个月 ，恢复良好。结论：浅低温心脏不停跳心内直视手术，是一种有效的心肌保护方 法，能减少并发症的发生，缩短体外循环时间。