Bypass surgery for quadruple syndrome

Fallot's syndrome is the most common type of purple congenital heart disease. There is no treatment for Faul's disease. At the age of six months of birth, ten percent will die. Less than 10% of patients can live to twenty. When a baby with such a disease is fortunate enough to live to a child's time, the purple will become more and more obvious. After such a surgical correction surgery, the lips and nails can become reddish, almost the same skin color as normal people. It is generally necessary to perform a bypass surgery for quadruple syndrome. Treatment of diseases: tetralogy of Fallot in children with tetralogy of Fallot Indication 1. Severe neonates with quadriplegia and pulmonary valve dysfunction are often ineffective in medical treatment, and one-stage intracardiac repair surgery is performed in emergency. 2. After the patient has passed the infancy, the patient should be scheduled to undergo surgery at 3 to 5 years of age. Preoperative preparation 1. Severe babies have severe breathing difficulties after birth, prone position can alleviate symptoms. Timely tracheal intubation for mechanically assisted breathing. 2. Actively treat metabolic acidosis and heart failure, as well as sucking and keeping the airway open. 3. Apply an echocardiogram to determine the diagnosis and perform an intracardiac repair operation as soon as possible. 4. The preoperative preparation of mild patients is similar to the simple tetralogy of Fallot. Surgical procedure After the patient enters the operating room, changing from the prone position to the supine position often causes severe cyanosis and life-threatening. At this time, ECG, arterial oxygen saturation and blood pressure should be monitored for tracheal intubation and mechanically assisted breathing in the prone or semi-prone position. After turning over, he was in supine position and was anesthetized. Extracorporeal circulation method and myocardial protection: application of deep hypothermia (16 ~ 18 ° C) to stop the circulation and cold blood cardioplegic coronary perfusion and local heart cooling to protect the myocardium. 1. The median incision in the chest removes most of the thymus. 2. Insert the arterial infusion tube through the ascending aorta and directly insert the right and inferior vena cava into the right angle tube. 3. After the bypass and cardiac arrest, the right atrium was opened and inserted into the left heart decompression tube through the patent foramen ovale. 4. Excision of the appropriate amount of tumor to enlarge the pulmonary trunk and the anterior and posterior walls of both pulmonary arteries, and suture the pulmonary artery incision with 6-0 or 7-0 polypropylene thread. Children's Hospital believes that only this method can effectively and evenly reduce the diameter of the pulmonary artery to reach the size of the normal pulmonary artery. The ventricular septal defect was repaired through the right ventricle longitudinal incision, and then the right ventricle to the pulmonary artery of the same species was performed. complication 1. Respiratory insufficiency and inability to ventilate from the ventilator: due to changes in the surrounding pulmonary plexus and the softening of the surrounding bronchus and alveolar reduction, patients with this deformity may deteriorate after the ventilator is removed, and arterial oxygen saturation decreases and As the carbon monoxide tension rises, the mechanically assisted breathing must continue to be applied again by endotracheal intubation or tracheotomy. If severe pulmonary regurgitation is found, the same aortic valve should be used to connect the right ventricle to the pulmonary artery. Once the ventilator cannot be removed from the ventilator multiple times, intermittent assisted breathing is used to gradually extend the time of spontaneous breathing until the ventilator is disengaged. 2. Pulmonary infection: This is a frequent complication of postoperative patients with this deformity, using antibiotics and nebulization. 3. Pulmonary regurgitation and right heart failure: Mild pulmonary valve insufficiency after intracardiac repair, pulmonary artery angioplasty, and right ventricle-to-pulmonary valve drainage, the patient can tolerate. In patients with severe pulmonary regurgitation and right heart failure after right ventricular outflow tract patch, the same type of aortic extracardiac duct should be used or a prosthetic valve placed at the pulmonary valve annulus. 4. Extracardiac obstruction: The patient has progressive endurance after surgery, and the extracardiac tube should be replaced in time by echocardiography.