A narrow therapeutic measure _'s treatment of lung artery

A narrow therapeutic measure _'s treatment of lung artery
Lung artery mouth narrow to mean right ventricle funnel portion, lung the intersection of artery and petal or lung artery doing and branch place narrow always, it can have alone or as other hearts, dirty and odd-shaped happy blocks of four of component such as law,etc.. Morbidity its account for congenital heart disease 10% about, artery mouth narrow lung petal narrow and most common with the intersection of lung and artery, account for 90%, it is narrow for the funnel one secondly, the pulse artery is done and the branch is narrow and rare. All kinds of lung the intersection of artery and the intersection of mouth and narrow their embryo the intersection of development and the intersection of obstacle and reason differ, in the 6th week such as development such as embryo, the artery bes and begins to separate and become aorta and lung artery, begin to form the primitive tubercles of three valves in the membrane in of lung artery, and grow in, then absorb and change thinly and form three lung artery ones, such as the valve is growing up the obstacle is taking place in the course, merge and become a dome-shaped mouth mouth that break out in juncture of three leaves, namely form the lung artery one is narrow. In lung while of a development of artery, taper department of the intersection of heart and ball is absorbed and flows out dish (funnel department) as the right ventricle ,If development obstacle form, flow out dishes of plump ring muscle and loose the intersection of skin and bunch span the intersection of room and wall and form right ventricle, flow out dishes of narrow funnel type promptly among the interval. In addition in the embryo's development course, the 6th becomes the left, right lung artery to the development of arch of aorta, it carry until lung arteriolar to link far, near end link with pulmonary trunk, until the intersection of development and obstacle form pulse promptly artery branch or pulmonary trunk narrow.
Slight lung artery narrow to have symptom at the clinical patient, can grow and meet normal viability, need surgery to treat normally, medium-sized degrees of the intersection of lung and the intersection of artery and narrow patient, appear out of breath state of palpitation under activity while being about 20 years old generally, if does not adopt the surgery treatment, will inevitablely lead to the fact with the years the load of right ventricle is overweight to present depleted symptom of the right heart, thus lose life and labour capacity and often present obvious symptom to the narrow patient of extremely severe lung artery in infancy, if it can often be in the death in infancy not to treat in time.
(1) Operation indication The intersection of patient and symptom, electrocardiogram have, change unusually obviously, right heart conduit check, show right the intersection of room and systolic pressure in 8.0kPa( 60mmHg) The above, or it is greater than 5.3kPa( 40mmHg) badly to step a pressure rank ,Or supersound aroused in interest to pursue, check, show petals of hole, belong to intermediate to should consider surgery while being narrow in 1.0- 1.5cm. There is not symptom but the heart electricity illustrationally shows right ventricular hypertrophy or with straining, it has intermediate persons who increase that slice shows the heart in the X-ray. There are symptom electrocardiogram and X-ray that have persons who unusually change, age of operation is by implementing preschoolly for being good. Symptom have, faint, break out history belong to extremely getting narrow, should until baby perform a surgical operation by lightening the load of right ventricle infancy obviously.
(2) Operation method Lung artery one narrow at intermediate low-temperature generally in the past ' 30- 32 ) Implement ocular to depend on membrane juncture cut skill, low-temperature method simple and convenient, until physiological disorder of function less in the body, resume smoothly while being postoperative, but because low temperature only can offer, circulate, block 6- 8 minutes such as time limit safely, must finish to operate hurriedly in the heart, and does not have abundant time to ascertain and correct and manage the deformity in the heart. Extracorporal circulatory system becoming better and approaching perfection day by day in recent years, myocardium protection and the intersection of operation and progress of skill make in the heart regarding performing the operation as safe direct, therefore lung the intersection of artery and the intersection of mouth and narrow operation adopt extracorporal circulatory system generally direct-view correct cure skill in the lower heart.
1.Cut the skill in a petal of direct-view of lung artery at low temperatureSuitable for getting simple artery petal narrow lung only, and condition to have, continue person who send funnel a narrow and other companions take place the deformity in the heart.
After trachea intubate anaesthetize, steep, enter patient competent body surface cool in the frozen water, wait nasopharyngeal temperature drop to at 35 surfacing, dry the body, the body temperature will continue dropping to 32- 30 .
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