Li Shoujun.Frontiers in surgical management of double outlet right ventricle: biventricular repair is a preferred strategy[J].Journal of Clinical Pediatric Surgery,2021,20(06):501-505.[doi:10.12260/lcxewkzz.2021.06.001]
右室双出口外科治疗进展——双心室矫治是首选
- Title:
- Frontiers in surgical management of double outlet right ventricle: biventricular repair is a preferred strategy
- Keywords:
- Double Outlet Right Ventricle/SU; Double Outlet Right Ventricle/CL; Heart Defects; Congenital/SU; Heart Defects; Congenital/DI; Clinical Protocols; Treatment Outcome
- 分类号:
- R541.1;R493.28;R322.11
- 摘要:
- 右室双出口（double outlet right ventricle，DORV）是病理解剖复杂多样的一类先天性心脏病，其外科手术方式多样，主要以双心室解剖矫治及单心室姑息治疗为主。不同病理解剖类型的DORV手术复杂程度不同，随着技术的进步和规范，对于左右心室发育均衡、房室瓣功能尚佳的DORV患者，双心室矫治是手术治疗的优选策略。
- Abstract:
- Double-outlet right ventricle (DORV) is a complex congenital heart disease encompassing various common and rare subtypes.Two major surgical approaches of biventricular repair and single ventricular palliation are routinely applied.Surgery remains rather complicated in some subtypes of DORV.With ongoing development and standardization of surgical managements and techniques,biventricular repair has become a preferred option for DORV.
参考文献/References:
1 Goor DA,Dische R,Lillehei CW,et al.The conotruncus.I.Its normal inversion and conus absorption[J].Circulation,1972,46(2):375-384.DOI:10.1161/01.CIR.46.2.375.
2 Van Praagh R,Van Praagh S,Nebesar RA,et al.Tetralogy of Fallot:underdevelopment of the pulmonary infundibulum and its sequelae[J].Am J Cardiol,1970,26(1):25-33.DOI:10.1016/0002-9149(70)90754-X.
3 Walters HL 3rd,Mavroudis C,Tchervenkov CI,et al.Congenital Heart Surgery Nomenclature and Database Project:double outlet right ventricle[J].Ann Thorac Surg,2000,69(4 Suppl):249-263.DOI:10.1016/S0003-4975(99)01247-3.
4 Anderson RH,Becker AE,Wilcox BR,et al.Surgical anatomy of double-outlet right ventricle-a reappraisal[J].Am J Cardiol,1983,52(5):555-559.DOI:10.1016/0002-9149(83)90025-5.
5 Lev M,Bharati S,Meng CC,et al.A concept of double-outlet right ventricle[J].J Thorac Cardiovasc Surg,1972,64(2):271-281.
6 Lacour-Gayet F,Maruszewski B,Mavroudis C,et al.Presentation of the International Nomenclature for Congenital Heart Surgery.The long way from nomenclature to collection of validated data at the EACTS[J].Eur J Cardiothorac Surg,2000,18(2):128-135.DOI:10.1016/S1010-7940(00)00463-2.
7 Jonas RA,Chief editor.Comprehensive Surgical Management of Congenital Heart Disease[M].Boca Raton:CRC Press,2004,413-428.DOI:10.1201/b13620.
8 Lacour-Gayet F.Biventricular repair of double outlet right ventricle with noncommitted ventricular septal defect[J].Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu,2002,5:163-172.DOI:10.1053/pcsu.2002.31491.
9 Kirklin JW,Harp RA,Mcgoon DC.Surgical treatment of origin of both vessels from right ventricle,including cases of pulmonary stenosis[J].J Thorac Cardiovasc Surg,1964,48:1026-1036.DOI:10.1016/S0007-0971(64)80007-3.
10 Li S,Ma K,Hu S,et al.Surgical outcomes of 380 patients with double outlet right ventricle who underwent biventricular repair[J].Journal of Thoracic & Cardiovascular Surgery,2014,148(3):817-824.DOI:10.1016/j.jtcvs.2014.06.020.
11 王顺民,徐志伟,陆兆辉,等.按STS-EACTS数据库分类的右室双出口手术方法和结果分析[J].中华小儿外科杂志,2007,28(5):225-227.DOI:10.3760/cma.j.issn.0253-3006.2007.05.001. Wang SM,Xu ZW,Lu ZH,et al.Approaches and outcomes of double-outlet ventricle based upon the STS-EACTS database classification[J].Chin J Pediatr Surg,2007,28(5):225-227.DOI:10.3760/cma.j.issn.0253-3006.2007.05.001.
12 陈纲,贾兵,陈张根,等.儿童复杂先天性心脏病肺动脉环缩术后二期手术时机的探讨[J].临床小儿外科杂志,2008,7(2):33-36.DOI:10.3969/j.issn.1671-6353.2008.02.010. Chen G,Jia B,Chen ZG,et al.Optimal timing of second stage procedure after pulmonary artery banding in children with complex congenital heart defect[J].J Clin Ped Sur,2008,7(2):33-36.DOI:10.3969/j.issn.1671-6353.2008.02.010.
13 莫绪明.重视婴幼儿复杂及重症先天性心脏病的早期外科治疗[J].临床小儿外科杂志,2009,8(1):4-7.DOI:10.3969/j.issn.1671-6353.2009.01.002. Mo XM.Paying great attention to early surgery for complicated and critical congenital heart diseases in infants and toddlers[J].J Clin Ped Sur,2009,8(1):4-7.DOI:10.3969/j.issn.1671-6353.2009.01.002.
14 花中东,李守军.先天性心脏病外科治疗中国专家共识(八):单心室生理矫治系列手术[J].中国胸心血管外科临床杂志,2020,27(9):979-986.DOI:10.7507/1007-4848.202005074. Hua ZD,Li SJ.Chinese Expert Consensus VⅢ on Surgery for Congenital Heart Diseases:Serial Single-Ventricle Physiological Correction[J].Chinese Journal of Clinical Thoracic and Cardiovascular Surgery,2020,27(9):979-986.DOI:10.7507/1007-4848.202005074.
15 张本青,马凯,刘锐,等.三尖瓣处理技术在远离型右心室双出口矫治患儿中的应用效果[J].中国循环杂志,2020,35(6):68-71.DOI:10.3969/j.issn.1000-3614.2020.06.011. Zhang BQ,Ma K,Liu R,et al.Efficacy of combined tricuspid management technique in biventricular repair for children with double outlet right ventricle complicating with non-committed ventricular septal defect[J].Chinese Circulation Journal,2020,35(6):68-71.DOI:10.3969/j.issn.1000-3614.2020.06.011.
16 Lacour-Gayet F,Haun C,Ntalakoura K,et al.Biventricular repair of double outlet right ventricle with non-committed ventricular septal defect (VSD) by VSD rerouting to the pulmonary artery and arterial switch[J].Eur J Cardiothorac Surg,2002,21(6):1042-1048.DOI:10.1016/s1010-7940(02)00105-7.
17 Hu SS,Xie YQ,Li SJ,et al.Double-root translocation for double-outlet right ventricle with noncommitted ventricular septal defect or double-outlet right ventricle with subpulmonary ventricular septal defect associated with pulmonary stenosis:an optimized solution[J].Ann Thorac Surg,2010,89(5):1360-1365.DOI:10.1016/j.athoracsur.2010.02.007.
18 Li SJ,Ma K,Hu SS,et al.Biventricular repair for double outlet right ventricle with non-committed ventricular septal defect[J].Eur J Cardiothorac Surg,2015,48(4):580-587.DOI:10.1093/ejcts/ezu523.
19 Lu T,Li J,Hu JG,et al.Biventricular repair of double-outlet right ventricle with noncommitted ventricular septal defect using intraventricular conduit[J].J Thorac Cardiovasc Surg,2020,159(6):2397-2403.DOI:10.1016/j.jtcvs.2019.07.084.
20 逄坤静,孟红,王浩,等.先天性右心室双出口的新分型方法及其对术式选择的指导作用[J].中华心血管病杂志,2015,43(11):969-974.DOI:10.3760/cma.j.issn.0253-3758.2015.11.010. Pang KJ,Meng H,Wang H,et al.Value of a novel categorization of congenital double-outlet right ventricle on guiding the choice of surgical approaches[J].Chin J Cardiol,2015,43(11):969-974.DOI:10.3760/cma.j.issn.0253-3758.2015.11.010.
21 花中东,杨新令,刘凯飏,等.应用 3D 打印技术改进远离型右心室双出口的外科治疗结果[J].中国胸心血管外科临床杂志,2016,23(6):532-536.DOI:10.7507/1007-4848.20160128. Hua ZD,Yang XL,Liu KY,et al.Application of 3D printing for improving surgical outcomes of double outlet right ventricle with non-committed ventricular septal defect[J].Chin J Clin Thorac Cardiovasc Surg,2016,23(6):532-536.DOI:10.7507/1007-4848.20160128.
22 张本青,马凯,李守军.先天性心脏病外科治疗中国专家共识(七):右心室双出口[J].中国胸心血管外科临床杂志,2020,27(8):851-856.DOI:10.7507/1007-4848.202004029. Zhang BQ,Ma K,Li SJ.Chinese expert consensus on surgical treatment of congenital heart disease (VⅡ):Double Outlet Right Ventricle[J].Chin J Clin Thorac Cardiov Surg,2020,27(8):851-856.DOI:10.7507/1007-4848.202004029.
备注/Memo
收稿日期:2021-04-10;。
基金项目:十三五国家重点研发计划（编号：2017YFC1308100）
通讯作者:李守军,Email:drlishoujun@yahoo.com