关键词: 三尖瓣下移畸形； 锥形重建术； 双向腔肺分流术

Abstract: Objective To explore the application of three different surgical methods in Carpentier C-type Ebstein’s anomaly (EA). Methods The clinical data of Carpentier C-type EA in 39 children who underwent surgery from June 2011 to August 2017 were retrospectively analyzed. Results A total of 39 children (18 boys and 21 girls) with Carpentier C-type EA were included. The median age was 28.3 (11.7-63.4) months and the median weight was 12.6 (8.7-19.2) kg. Among them, 13 patients underwent cone reconstruction (CR) surgery only (group A), 18 patients underwent CR combined with bidirectional cavo-pulmonary shunt (BCPS, group B), and 8 patients only underwent BCPS (group C). There were significant differences in the proportion of preoperative cyanosis and cardiac function classification among the three groups (P< 0 . 05 ). The children in group C had a higher proportion of preoperative cyanosis and worse cardiac function (grade Ⅲ and Ⅳ). The differences in the cardiopulmonary bypass (CPB) time, aortic cross-clamp (ACC) time, mechanical ventilation time, ICU stay time, postoperative hospital stay, incidence of low cardiac output syndrome, treatment cost during hospitalization and follow-up time among the three groups were statistically significant (P< 0 . 05 ). Pairwise comparisons showed that the CPB time, ACC time, mechanical ventilation time, ICU stay time, and postoperative hospital stay of group B were longer than those of group C, while the treatment cost during hospitalization of group C was higher than that of group A, and the differences were statistically significant (P

Key words: Ebstein’s anomaly; cone reconstruction; bidirectional cavo-pulmonary shunt