2019 年第 10 期 第 14 卷

法洛四联症矫治术后远期肺动脉瓣关闭不全的治疗进展

Research progress of chronic pulmonary insufficiency following repair of tetralogy of Fallot

作者：李墨琦金梅

英文作者：

单位：100029首都医科大学附属北京安贞医院小儿心脏中心北京市心肺血管疾病研究所

英文单位：

关键词：法洛四联症；肺动脉瓣关闭不全；肺动脉瓣置换术；经皮导管肺动脉瓣置换术；镶嵌治疗

英文关键词：

• 摘要：

• 【摘要】肺动脉瓣关闭不全是法洛四联症矫治术后最常见的并发症之一，轻中度反流在早期可以得到良好的耐受，但长期的肺动脉瓣反流会引起右心室扩大、右心室功能不全，甚至引发心源性猝死，严重影响患者的预后和远期生存率。目前治疗肺动脉瓣关闭不全的方法有肺动脉瓣置换术、经皮导管肺动脉瓣置换术和镶嵌治疗，随着相关研究的深入和手术器材的改进，肺动脉瓣反流的手术指征和治疗策略也在不断更新。现就法洛四联症术后远期肺动脉瓣关闭不全的病理生理以及治疗进展进行综述。

• 【Abstract】Pulmonary insufficiency(PI) is one of the most common complications of tetralogy of Fallot(TOF). Mild to moderate pulmonary regurgitation can be tolerated in early postoperative period. However, subsequent chronic complications such as right ventricular dilation and right ventricular dysfunction may cause sudden cardiac death and severe threat on the long-term prognosis and survival. Current treatment for PI mainly includes pulmonary valve replacement, percutaneous pulmonary valve implantation and hybrid procedures. Criteria pertaining to referral strategies are ever being refined with the progress of researches and improvement of surgical equipments. In this article, we reviewed the pathophysiological changes and clinical progress of chronic PI following TOF repair.