Intrapericardial Ligation of Patent Ductus Arteriosus through Median Sternotomy / 第三军医大学学报

Twelve cases of patent ductus arteriosus (PDA) were treated with intraperi-cardial ligation through a median sternotomy during a 4-year period from 1980 to 1983. Among the 12 cases, 5 were associated with ventricular septum defect, 1 was complicated with right descending thoracic aorta and the ductus was situated at the right side of mediastinum, 1 case had the anomaly of type Ⅲ aor-tico-pulmonary window and PDA coexisted with that anomaly.A new surgical approach to the intrapericardial ligation of patent ductus arteriosus through a median sternotomy was suggested as follows:(1) Thorough dissection is done to isolate the ascending aorta completely from the main pulmonary artery.(2) A thread is passed around the upper part of the ascending aorta and pull it rightward.(3) A right angled retractor is placed under the upper edge of the fsternal incision and pull it leftward.(4) An assistant retracts the pulmonary artery downward to put the artery on tesion.It was suggested that exploration of the PDA area be a routine procedure before extracorporeal circulation is exployed.Furthermore.intrapericardial ligation of patent ductus arteriosus is one of the basic procedures a cardiac surgeon must be skillful at.

Study on Predisposing Factors of Low Cardiac Output Syndrome after Corrective Surgery for Tetralogy of Fallot / 第三军医大学学报

One hundred and seven cases of tetralogy of Fallot (TOF) were surgically corrected in this institute in the period from Jan 1983 to Dec 1989. Adequate corrective procedures were performed in 106 cases and aorto-pulmo-nary shunt with 1.2 Dacron tube in one. The corrective procedures employed included simple intracardiac repair in 18, subpulmonary RV outflow patch in 50, transannular RV outflow patch in 37, and RV-PA coronary conduit in 1 because of anomalous right coronary artery. The operative mortality rate was 13% , and the main complication was low cardiac output syndrome (LCOS) , which occurred in 26 cases (24%) .It was found that the predisposing factors of LOS after corrective surgery for TOF were serious clinical manifestations of the patient before operation, and residual right ventricular outflow tract obstruction due to improper repair of the right ventricular outflow tract, which were fatal in some cases.

Total Anomalous Pulmonary Venous Drainage -Report of Three Cases / 第三军医大学学报

This article is to report three cases of total anomalous pulmonary venous drainage(TAPVD). 2 out of the 3 cases were of the supracardiac form and they were corrected by anastomosis between the trunk of the pulmonary vein and the left atrium with excellent result. The third case was of the intracardiac form. The patient died in the late postoperative period of pulmonary venous obstruction due to the improper judgement during the operative procedure of compartmentalization. Meanwhile, the embryogensis, clinical manifestations, diagnosis, and operative proceduresfof TAPVD were reviewed and discussed.