Tetralogy of Fallot: Animation Explains Heart Defect and Repair

法洛四聯(lián)癥：動(dòng)畫解讀心臟缺陷及其修復(fù)

The Heart Center at Nationwide Children's is dedicated to the unique needs of its patients. One of the conditions the center supports is tetralogy of fallot. Tetralogy of fallot is a heart defect made up of four heart problems. It results in cyanotic or blue babies. The four heart problems are ventricular septal defect, overriding aorta, pulmonary stenosis and right ventricular hypertrophy. 

全美兒童心臟中心致力于為每位兒童提供最優(yōu)質(zhì)的醫(yī)療服務(wù)。該中心主治的其中一種疾病為法洛四聯(lián)癥（tetralogy of fallot）。法洛四聯(lián)癥是一種心臟缺陷，由四種心臟疾病組成；導(dǎo)致嬰兒發(fā)紺或呈青紫色。這四種心臟疾病為室間隔缺損（ventricular septal defect），主動(dòng)脈騎跨（overriding aorta），肺動(dòng)脈狹窄（pulmonary stenosis）以及右心室肥大（right ventricular hypertrophy）。

A ventricular septal defect is a hole in the wall between the two lower chambers of the heart called the ventricles. The hole allows oxygen-rich blood to mix with oxygen-poor blood. Normally the aorta attaches to the left ventricle which pumps oxygen-rich blood through it.

室間隔缺損指心臟下方的兩個(gè)腔室壁，即心室壁之間出現(xiàn)孔洞。這樣，富氧血液將通過孔洞與缺氧血液混合。正常情況下，主動(dòng)脈與左心室相連，而左心室負(fù)責(zé)泵出富氧血液。

In an overriding aorta, the aorta has moved forward directly over the hole between the ventricles. This allows oxygen poor blood from the right ventricle to flow into the aorta. Pulmonary stenosis means that the blood vessel going to the lungs called the pulmonary artery is narrowed and the pulmonary valve doesn't open all the way. As a result, less blood reaches the lungs. These heart problems cause the baby to be blue because the heart pumps less oxygen-rich blood to the body. 

主動(dòng)脈騎跨指主動(dòng)脈直接向前移動(dòng)至心室間的孔上。這樣，右心室內(nèi)的缺氧血液將流入主動(dòng)脈。肺動(dòng)脈狹窄指通向肺部的血管，即肺動(dòng)脈，變得狹窄，肺動(dòng)脈瓣未完全打開。因此，流入肺部的血液會(huì)更少。這些心臟疾病會(huì)導(dǎo)致嬰兒呈青紫色，因?yàn)樾呐K向全身泵送的富氧血液較少。

Right ventricular hypertrophy means the wall of the right ventricle is thicker than normal. This happens because the right ventricle has to work harder to pump blood through the narrowed pulmonary valve. 

右心室肥大指右心室壁較正常心室壁厚。這是肺動(dòng)脈瓣狹窄，致使右心室更用力泵送血液導(dǎo)致的。

Treatment for tetralogy of fallot may include temporary and complete surgical repair procedures. Sometimes a child is not ready for a complete repair right away. In this case, a temporary repair called a shunt can be placed until a complete repair can be done. The shunt improves oxygen levels in the blood. 

法洛四聯(lián)癥的治療方案可能包括臨時(shí)以及完全外科修復(fù)術(shù)。有些嬰兒無法立即行完全修復(fù)術(shù)，此時(shí)，需要植入分流管進(jìn)行暫時(shí)修復(fù)，以期后期行完全修復(fù)治療。分流管可以改善血液的氧氣水平。

During this procedure, the surgeon will place a tube called a shunt between a branch of the aorta and the right pulmonary artery. The shunt will provide another path for blood to get to the lungs to pick up oxygen. 

術(shù)中，醫(yī)生將在主動(dòng)脈分支和右肺動(dòng)脈之間植入分流管。分流管將成為血液進(jìn)入肺部，獲取氧氣的另一種途徑。

Instead of a shunt, another temporary procedure can be done. In this procedure, a device called a stent is placed in the narrow area to allow more blood to flow to the lungs. 

除了分流管之外，我們還可以行另外一種臨時(shí)手術(shù)，即在狹窄區(qū)域植入支架，使更多血液流向肺部。

Most patients have a complete repair at four to six months of age. If the main pulmonary artery is too small, it will be widened with a patch. If the pulmonary valve is too small, it may be widened with a patch called a transannular patch. If the narrowing is below the pulmonary valve, the surgeon will remove some of the heart muscle in this area. This improves the flow of oxygen poor blood from the right ventricle to the lungs. 

大多數(shù)嬰兒在4至6個(gè)月時(shí)行完全修復(fù)術(shù)。如果主肺動(dòng)脈太狹小，那么醫(yī)生將使用補(bǔ)片擴(kuò)寬；如果肺動(dòng)脈瓣過于狹小，可以使用跨環(huán)補(bǔ)片擴(kuò)寬；如果狹窄部位位于肺動(dòng)脈瓣下方，醫(yī)生將切除該區(qū)域的部分心肌。這將促進(jìn)來自右心室的缺氧血液流向肺部。

To fix the ventricular septal defect, the surgeon will cover the hole with a patch. The patch prevents the mixing of oxygen poor blood with oxygen-rich blood. As a result, only oxygen-rich blood flows out of the aorta to the body from the left ventricle.

修復(fù)室間隔缺損時(shí)，醫(yī)生將使用補(bǔ)片覆蓋孔洞。補(bǔ)片可以預(yù)防缺氧血液與富氧血液混合。因此，僅富氧血液自左心室泵入主動(dòng)脈，然后流向全身。