Surgical treatment of pulmonary atresia with intact ventricular septum / 国际儿科学杂志

ABSTRACT

Pulmonary atresia with intact ventricular septum(PA/IVS) is one of the complicated cyanotic congenital heart diseases with high mortality,which needs early intervention after birth.With further understanding of the disease and the development of surgery,the operative plan of the disease is gradually changing and some fundamental changes have taken place.The hemodynamic awareness of the disease is an important factor in the selection of surgery and the improvement of prognosis.In addition,it is also important for the selection of surgery and the improvement of prognosis to evaluate the development degree of the right ventricle comprehensively and accurately.At present,it is generally believed that the most effective treatment strategy can be obtained by classifying the development degree of the right ventricle in morphology.The surgical treatment has developed from early surgical pulmonary bypass to the interventional and hybrid surgery,which greatly improves prognosis and reduces surgical trauma.Among them,the pereutaneous pulmonary valve radiofrequency perforation plus balloon dilation and PDA stent implantation can be used as the preferred treatment for PA/IVS with dysplasia of the right ventricle.Particularly,PA/IVS can be cured with the interventional surgery alone for children with mild or even moderate dysplasia of the right ventricle.Hybrid surgery that significantly reduces trauma compared with traditional surgery is also an important choice for the areas where interventional surgery is relatively outdated.This article reviews and summarizes the progress of recognition and surgical treatment of PA/IVS,in order to provide reference for the clinical diagnosis and treatment.