Pulmonary artery trunk reconstruction after pulmonary artery retraction

Pulmonary artery atrophy was first proposed by Muller et al in 1952 as a palliative surgical procedure for the treatment of large ventricular septal defect and other large left-to-right shunts. For some infants, large ventricular septal defect with severe pulmonary hypertension is difficult to tolerate. Direct vision surgery, the application of pulmonary trunk retraction, can improve right ventricular pressure, reduce left to right shunt, reduce left and right heart load, to control congestive heart failure, prevent or prevent progressive changes in pulmonary arterioles. Some scholars claim that the pulmonary artery can expand after the bandage of the narrowed pulmonary artery is removed during ventricular septal defect repair. But in fact, it is often necessary to reconstruct the pulmonary artery to avoid residual pressure gradients. Treatment of diseases: ventricular septal defect Indication Pulmonary artery reconstruction after pulmonary artery contraction is suitable for patients with ventricular septal defect surgery after the child has passed the dangerous period and grows up. Preoperative preparation Prepare routinely before surgery. Surgical procedure Establish extracorporeal circulation. When the cardiopulmonary perfusion is performed, the transverse incision through the right ventricular outflow tract extends into the finger to probe, and the pulmonary artery is longitudinally cut at the band, and the band is partially or completely removed. Excision of the sputum caused by the band in the pulmonary artery lumen. The fine lines were used to suture the residual margin of the residual stenosis in the pulmonary artery lumen. For some larger pulmonary arteries, the longitudinal incision can be used for intermittent transverse sutures. When the stenosis cannot be sufficiently relieved by the longitudinal slitting method, the pericardial or PTFE sheet can be used to repair the pulmonary artery incision, and generally satisfactory results can be obtained. During the post-growth follow-up of the diseased children who were treated as described above, turbulence and residual pressure difference were sometimes found locally during cardiac catheterization. Therefore, Stark suggested the use of resection of the pulmonary artery constriction for end-to-end anastomosis, due to pulmonary artery trunk during radical surgery. The caliber is large enough, and the suture can be sutured continuously. This operation can receive better results, but because of the wide peeling surface, it will increase the early postoperative bleeding, which should be seriously considered. Postoperative diet 1. Give high protein, high vitamin and cellulose-rich digestible diet. 2, do not eat spicy spicy food.