先天性冠状动脉起源异常病理解剖及胚胎学与外科治疗

先天性冠状动脉起源异常病理解剖及胚胎学与外科治疗[J]. 实用临床医药杂志, 2009, (9): 9-12.
引用本文: 先天性冠状动脉起源异常病理解剖及胚胎学与外科治疗[J]. 实用临床医药杂志, 2009, (9): 9-12.
Pathological anatomy, Embryology and surgical treatment of Congenital Anomalous Origin of Coronary Artery[J]. Journal of Clinical Medicine in Practice, 2009, (9): 9-12.
Citation: Pathological anatomy, Embryology and surgical treatment of Congenital Anomalous Origin of Coronary Artery[J]. Journal of Clinical Medicine in Practice, 2009, (9): 9-12.

先天性冠状动脉起源异常病理解剖及胚胎学与外科治疗

详细信息
  • 中图分类号: R.654

Pathological anatomy, Embryology and surgical treatment of Congenital Anomalous Origin of Coronary Artery

  • 摘要: 目的 总结先天性冠状动脉起源异常病理解剖和胚胎学与外科治疗.方法 回顾分析阜外医院1998年2月到2007年8月先天性冠状动脉起源异常并进行外科手术病例,其中24例患者冠状动脉起源于肺动脉,男13例,女11例;年龄3月到41岁.左冠状动脉起自肺动脉14例;右冠状动脉起自肺动脉10例.按Leiden冠状动脉分型方法 进行冠状动脉分型.左冠状动脉起自肺动脉14例均在体外循环下进行手术,直接冠状动脉移植12例,肺动脉内隧道2例.右冠状动脉起自肺动脉10例中2例在非体外下进行冠状动脉移植, 1例合并房间隔缺损进行房间隔封堵术, 2例进行肺动脉内隧道, 6例进行了直接移植.1997年10月~2007年8月 共完成动脉掉转手术170例,采用Leiden冠状动脉分型方法 , 1LCx2R为冠状动脉正常分布,其余分类形式为冠状动脉异常分布,冠状动脉异常起源48例,有3例冠状动脉壁内走行;男28例,女20例 ,年龄4天~6岁;简单型大动脉转位中18例冠状动脉异常起源,复杂型大动脉转位中15例冠状动脉异常起源, T-B中15例冠状动脉异常起源.冠状动脉吻合主要采用带片开门技术或吊窗技术.结果冠状动脉起源于肺动脉病例中,左冠状动脉均起自肺动脉窦1, 右冠状动脉均起自肺动脉窦2;异常肺动脉起源的冠状动脉冠状动脉再移植无手术死亡.动脉掉转手术冠状动脉异常起源48例中,其中1L2RCx 占18例、1R2LCX 7例、1LR2Cx 6例、2LCx2R 6例、2LCxR 5例.异常主动脉起源的冠状动脉冠状动脉再移植死亡9例,死亡率为18.7%.其中2004年前死亡7例,死亡率29.2%(7/24), 2004年后死亡2例,死亡率8.3%(2/24).结论提高对先天性冠状动脉起源异常的病理解剖,胚胎发生学的认识有助于提高手术疗效.
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  • 发布日期:  2009-11-29

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