Children with tetralogy of Fallot radical of 32 cases _6788

[wlsqfjaru]

Children with tetralogy of Fallot 32 cases of radical mastectomy
 
 
Artery (9 cases more than about pulmonary artery branches), the merger is first patent ductus arteriosus closure, atrial septal defect in the patch after its closure. Aortic cross-clamping 38 ~ 58min, the average (41.0 ± 12. min, bypass 8O ~ 128min, the average (104.0 +21. min. Results severe low cardiac 1 (death), 2 cases of early postoperative right ventricular dysfunction occurred, and cured by medication. Survivors before discharge and after 1 month review, cardiac function recovered to grade I, ECG showed sinus rhythm, 3 cases with right bundle branch block; Cardiac Echocardiography of right ventricular outflow tract to clear the satisfaction, no case of residual shunt, 28 patients were followed up 2 to 96 months no late complications or death. On one or if preoperative preparation in children with malnutrition; 3 days before surgery to parenteral nutrition, such as poor cardiopulmonary function, oxygen given 5 to 7 days (2 times a day, every 2 units of ~ 215,003 small University of Cardiothoracic Surgery, Affiliated Children's Hospital one by one: Z: pm). Second, the induction of anesthesia to add sodium bicarbonate to prevent acidosis induced hypotension. Because of low blood pressure,You are not allowed to view links. Register or Login, left to right shunt increased, oxygen saturation can drop further, will enable organizations, particularly heart and lung hypoxia increased. Third, the satisfactory correction of heart defects is reasonable to ensure that key to successful operation. With the improvement of cardiac surgery, pulmonary poorly developed in the past that were not suitable for line of tetralogy of Fallot radical surgery of the standard has been relaxed, foreign scholars _1] have advocated radical surgery in early stage, age is no longer limited [2 ]. We appreciate the technical points,You are not allowed to view links. Register or Login, is good to clear the right ventricular outflow tract, right ventricular outflow tract in the expansion, you should carefully check the pulmonary artery (left branch is important to note), such as left and right pulmonary artery bifurcation, or about the beginning part of poorly developed, The patch must be extended to the bifurcation or the left pulmonary artery is about the beginning part. Moderate right ventricular outflow tract resection of abnormal muscle bundle hypertrophy, does not destroy the physical structure of myocardial contraction. VSD patch to be reliable, no residual shunt, no damage tracts. Outflow tract fill gap films, should ensure that internal diameter width. Infants younger than 3 years old baby JD:, right ventricular cavity should not cut too much abnormal muscle bundle, way off as far as possible,You are not allowed to view links. Register or Login, and to expand autologous pericardial right ventricular outflow tract. Fourth, the right pump bypass, with special emphasis during low-flow bypass must be deep hypothermia [3]. Particularly rich on the collateral, and more children with left ventricular drainage pole, but is surgery to repair the VSD, in order to maintain a clear surgical field, the use of low flow (3O ~ 50 · kg · min-), while low flows can reduce the pulmonary blood flow, thereby reducing the aggregation of white blood cells in the lungs, is conducive to the protection of the lung, but also reduce the damage of blood visible components and mechanical hemolysis. VSD repair completed,You are not allowed to view links. Register or Login, you can open the aorta, and then for the outflow tract widening, can shorten the time of myocardial ischemia and hypoxia is conducive to myocardial protection. Slower rewarming, nose and anus temperature difference of less than 3 ~ 5 ℃, for the younger age, low body weight, severe illness in children, pre-filled with gel-based,You are not allowed to view links. Register or Login, end of surgery plus ultrafiltration or furosemide, to reduce the incidence of postoperative perfusion lung. Fifth, postoperative care and after aortic surgery, routine use of dopamine 5pg · kg-· min_. , Low blood pressure and heart rate after surgery and children Slowly, add 3 to 5 with isoproterenol Asahi kg · m_in-micro pump infusion, increased heart rate, cardiac output to ensure sufficient. Poor peripheral circulation, such as limbs, in the case of blood pressure to ensure the application vasodilators sodium nitroprusside (O.5 ~ 5 Xu l · min-), reduced cardiac work and oxygen consumption, expansion of micro arteries, to improve tissue perfusion . Age of this group of early postoperative small alternating 1O chloral hydrate stability or to maintain absolute silence in children. Baozhengshuhou potassium, calcium and sugar, the normal levels, the support of better nutrition. ,