{"id":31626,"date":"2023-05-04T18:39:15","date_gmt":"2023-05-04T11:39:15","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31626"},"modified":"2023-05-04T18:39:15","modified_gmt":"2023-05-04T11:39:15","slug":"phau-thuat-tim-bam-sinh","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/phau-thuat-tim-bam-sinh\/","title":{"rendered":"Ph\u1eabu thu\u1eadt tim b\u1ea9m sinh"},"content":{"rendered":"

Ph\u1eabu thu\u1eadt tim b\u1ea9m sinh<\/a> \u1edf tu\u1ed5i thanh thi\u1ebfu ni\u00ean v\u00e0 ng\u01b0\u1eddi l\u1edbn n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1ea1i c\u00e1c trung t\u00e2m chuy\u00ean v\u1ec1 tim b\u1ea9m sinh \u1edf ng\u01b0\u1eddi l\u1edbn. T\u1ea5t c\u1ea3 c\u00e1c ph\u1eabu thu\u1eadt tim b\u1ea9m sinh c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c h\u1ed9i ch\u1ea9n gi\u1eefa c\u00e1c b\u00e1c s\u0129 ph\u1eabu thu\u1eadt, b\u00e1c s\u0129 g\u00e2y m\u00ea tim, b\u00e1c s\u0129 n\u1ed9i tim m\u1ea1ch v\u00e0 h\u1ed3i s\u1ee9c \u0111\u1ec3 l\u00ean k\u1ebf ho\u1ea1ch can thi\u1ec7p m\u1ed9t c\u00e1ch r\u00f5 r\u00e0ng v\u00e0 t\u1ec9 m\u1ec9 cho t\u1eebng b\u1ec7nh nh\u00e2n.<\/strong><\/p>\n

1. T\u1ed5ng quan<\/h2>\n

Ph\u1eabu thu\u1eadt tim b\u1ea9m sinh \u1edf tu\u1ed5i thanh thi\u1ebfu ni\u00ean v\u00e0 ng\u01b0\u1eddi l\u1edbn n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1ea1i c\u00e1c trung t\u00e2m chuy\u00ean v\u1ec1 tim b\u1ea9m sinh \u1edf ng\u01b0\u1eddi l\u1edbn. T\u1ea5t c\u1ea3 c\u00e1c ph\u1eabu thu\u1eadt tim b\u1ea9m sinh c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c h\u1ed9i ch\u1ea9n gi\u1eefa c\u00e1c b\u00e1c s\u0129 ph\u1eabu thu\u1eadt, b\u00e1c s\u0129 g\u00e2y m\u00ea tim, b\u00e1c s\u0129 n\u1ed9i tim m\u1ea1ch v\u00e0 h\u1ed3i s\u1ee9c \u0111\u1ec3 l\u00ean k\u1ebf ho\u1ea1ch can thi\u1ec7p m\u1ed9t c\u00e1ch r\u00f5 r\u00e0ng v\u00e0 t\u1ec9 m\u1ec9 cho t\u1eebng b\u1ec7nh nh\u00e2n. C\u00f3 th\u1ec3 chia c\u00e1c b\u1ec7nh nh\u00e2n n\u00e0y th\u00e0nh ba nh\u00f3m:<\/p>\n

    \n
  • B\u1ec7nh nh\u00e2n ch\u01b0a tr\u1ea3i qua ph\u1eabu thu\u1eadt l\u1ea7n n\u00e0o<\/li>\n
  • B\u1ec7nh nh\u00e2n \u0111\u00e3 tr\u1ea3i qua c\u00e1c ph\u1eabu thu\u1eadt t\u1ea1m th\u1eddi tr\u01b0\u1edbc \u0111\u00f3<\/li>\n
  • B\u1ec7nh nh\u00e2n \u0111\u00e3 tr\u1ea3i qua c\u00e1c ph\u1eabu thu\u1eadt s\u1eeda to\u00e0n b\u1ed9 tr\u01b0\u1edbc \u0111\u00f3<\/li>\n<\/ul>\n

    C\u00e1c ph\u1eabu thu\u1eadt c\u01a1 b\u1ea3n c\u1ee7a tim b\u1ea9m sinh bao g\u1ed3m:<\/p>\n

    1.1 Ph\u1eabu thu\u1eadt l\u00e0m c\u1ea7u n\u1ed1i ch\u1ee7 – ph\u1ed5i (Blalock-Taussig shunt – vi\u1ebft t\u1eaft: BT shunt)<\/strong><\/p>\n

    L\u00e0 ph\u1eabu thu\u1eadt t\u1ea1o m\u1ed9t c\u1ea7u n\u1ed1i gi\u1eefa tu\u1ea7n ho\u00e0n h\u1ec7 th\u1ed1ng v\u00e0 tu\u1ea7n ho\u00e0n ph\u1ed5i <\/em><\/strong>nh\u1eb1m t\u0103ng l\u01b0u l\u01b0\u1ee3ng m\u00e1u l\u00ean ph\u1ed5i trong c\u00e1c b\u1ec7nh TBS c\u00f3 t\u00edm v\u1edbi gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng m\u00e1u l\u00ean ph\u1ed5i.<\/p>\n

      \n
    • C\u1ea7u n\u1ed1i Blalock-Taussig c\u1ed5 \u0111i\u1ec3n <\/em>s\u1eed d\u1ee5ng \u0111\u1ed9ng m\u1ea1ch d\u01b0\u1edbi \u0111\u00f2n c\u1ee7a ch\u00ednh b\u1ec7nh nh\u00e2n l\u00e0m c\u1ea7u n\u1ed1i (c\u1eaft \u0111\u1ed9ng m\u1ea1ch d\u01b0\u1edbi \u0111\u00f2n, th\u1eaft \u0111\u1ea7u ngo\u1ea1i vi v\u00e0 n\u1ed1i \u0111\u1ea7u trung t\u00e2m v\u1edbi \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i)<\/li>\n
    • C\u1ea7u n\u1ed1i Blalock-Taussig c\u1ea3i ti\u1ebfn <\/em>s\u1eed d\u1ee5ng m\u1ed9t \u0111o\u1ea1n m\u1ea1ch nh\u00e2n t\u1ea1o (Gore-Tex) l\u00e0m c\u1ea7u n\u1ed1i gi\u1eefa \u0111\u1ed9ng m\u1ea1ch d\u01b0\u1edbi \u0111\u00f2n v\u1edbi \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i.<\/li>\n<\/ul>\n

      M\u1ee5c \u0111\u00edch c\u1ee7a c\u1ea7u n\u1ed1i l\u00e0 l\u00e0m t\u0103ng l\u01b0\u1ee3ng m\u00e1u l\u00ean ph\u1ed5i <\/em><\/strong>c\u1ea3i thi\u1ec7n b\u00e3o h\u00f2a oxy trong c\u00e1c b\u1ec7nh l\u00fd tim b\u1ea9m sinh c\u00f3 t\u00edm do \u00edt m\u00e1u l\u00ean ph\u1ed5i. C\u1ea7u n\u1ed1i l\u00fd t\u01b0\u1edfng khi l\u01b0u l\u01b0\u1ee3ng m\u00e1u c\u00e2n b\u1eb1ng gi\u1eefa tu\u1ea7n ho\u00e0n h\u1ec7 th\u1ed1ng v\u00e0 tu\u1ea7n ho\u00e0n ph\u1ed5i (Qp\/Qs = 1) v \u00e0 \u0111\u1ea3m<\/p>\n

      b\u1ea3o \u0111\u01b0\u1ee3c m\u1ee9c b\u00e3o h\u00f2a oxy cho ph\u00e9p. Do \u0111\u00f3 vi\u1ec7c ch\u1ecdn k\u00edch th\u01b0\u1edbc c\u1ea7u n\u1ed1i c\u1ea7n d\u1ef1a v\u00e0o t\u1eebng t\u1ed5n th\u01b0\u01a1ng c\u1ee5 th\u1ec3, c\u00e2n n\u1eb7ng c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 m\u1ee9c b\u00e3o h\u00f2a oxy c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n

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      • C\u1ea7u n\u1ed1i Waterston <\/em>: N \u1ed1i \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00ean v\u1edbi \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i ph\u1ea3i, hi \u1ec7n \u00edt s\u1eed d\u1ee5ng.<\/li>\n
      • C\u1ea7u n\u1ed1i Pott <\/em>: N \u1ed1i \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 xu\u1ed1ng v\u1edbi \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i tr\u00e1i , hi\u1ec7n \u00edt s\u1eed d\u1ee5ng<\/li>\n<\/ul>\n

        1.2 Ph\u1eabu thu\u1eadt l\u00e0m c\u1ea7u n\u1ed1i t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean – \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i (Glenn shunt)<\/h3>\n

        \u0110\u01b0\u1ee3c coi l\u00e0 ph\u1eabu thu\u1eadt th\u00ec \u0111\u1ea7u <\/strong>tr\u01b0\u1edbc khi ph\u0201u thu\u1eadt Fontan (ph\u00e2n l\u01b0u to\u00e0n b\u1ed9 m\u00e1u c\u1ee7a h\u1ec7 th\u1ed1ng t\u0129nh m\u1ea1ch v\u1ec1 th\u1eb3ng \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i)<\/p>\n

        Ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/p>\n

        Trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p tim m\u1ed9t th\u1ea5t.<\/em><\/p>\n

        Tuy nhi\u00ean c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p s\u1eeda ch\u1eefa ki\u1ec3u m\u1ed9t – m\u1ed9t ph\u1ea7n hai th\u1ea5t <\/em>(one and a half ventricle repair): C h\u1ec9 \u0111\u1ecbnh trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p van ba l\u00e1\/ th\u1ea5t ph\u1ea3i thi\u1ec3u s\u1ea3n <\/em>, gi\u1ea3m ch\u1ee9c n\u0103ng nh\u01b0ng v\u0201n \u0111\u1ea3m b\u1ea3o \u0111\u01b0\u1ee3c m\u1ed9t ph\u1ea7n l\u01b0u l\u01b0\u1ee3ng m\u00e1u b\u01a1m l\u00ean ph\u1ed5i.<\/p>\n

        C\u1ea7u n\u1ed1i Glenn c\u1ed5 \u0111i\u1ec3n l\u00e0 k \u1ef9 thu\u1eadt c\u1eaft r\u1eddi \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i ph\u1ea3i kh\u1ecfi th\u00e2n \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i v\u00e0 n\u1ed1i v\u1edbi t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean.<\/p>\n

        Hi\u1ec7n nay ch\u1ee7 y\u1ebfu d\u00f9ng c\u1ea7u n\u1ed1i Glenn hai h\u01b0\u1edbng <\/em>(bidirectional Glenn shunt) b\u1eb1ng c\u00e1ch c\u1eaft r\u1eddi t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean \u1edf v\u1ecb tr\u00ed n\u1ed1i v\u1edbi nh\u0129 ph\u1ea3i v\u00e0 n\u1ed1i t\u1eadn-b\u00ean v\u1edbi \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i ph\u1ea3i. Nh\u01b0 v\u1eady m\u00e1u t\u1eeb t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean s\u1ebd \u0111i v\u1ec1 c\u1ea3 hai h\u01b0\u1edbng \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i ph\u1ea3i v\u00e0 \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i tr\u00e1i.<\/p>\n

        1.3 Ph\u1eabu thu\u1eadt Fontan<\/h3>\n

        L\u00e0 ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p tim m\u1ed9t th\u1ea5t <\/em>.<\/strong><\/p>\n

        Ph\u1eabu thu\u1eadt th\u01b0\u1eddng \u0111\u01b0\u1ee3c chia l\u00e0m hai th\u00ec:<\/p>\n

          \n
        • Th\u00ec m\u1ed9t: T\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean \u0111\u01b0\u1ee3c c\u1eaft r\u1eddi v\u00e0 n\u1ed1i t\u1eadn – b\u00ean v\u00e0o \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i (ph\u0201u thu\u1eadt Glenn hai h\u01b0\u1edbng)<\/li>\n
        • Th\u00ec hai: N \u1ed1i t\u0129nh m\u1ea1ch ch\u1ee7 d\u01b0\u1edbi v\u1edbi \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i (s\u1eed d\u1ee5ng m\u1ed9t \u0111o\u1ea1n m\u1ea1ch nh\u00e2n t\u1ea1o ho\u1eb7c l\u00e0m m\u1ed9t \u0111\u01b0\u1eddng h\u1ea7m trong nh\u0129 ph\u1ea3i n\u1ed1i v\u1edbi \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i).<\/li>\n<\/ul>\n

          Nh\u01b0 v\u1eady to\u00e0n b\u1ed9 m\u00e1u c\u1ee7a h\u1ec7 th\u1ed1ng t\u0129nh m\u1ea1ch \u0111\u01b0\u1ee3c ph\u00e2n l\u01b0u v\u1ec1 \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i v\u00e0 b\u1ecf qua vai tr\u00f2 c\u1ee7a th\u1ea5t ph\u1ea3i. M\u00e1u \u0111\u01b0\u1ee3c trao \u0111\u1ed5i oxy s\u1ebd tr\u1edf v\u1ec1 th\u1ea5t chung v\u00e0 b\u01a1m l\u00ean tu\u1ea7n ho\u00e0n h\u1ec7 th\u1ed1ng, do \u0111\u00f3 b\u1ec7nh nh\u00e2n kh\u00f4ng b\u1ecb t\u00edm m\u1eb7c d\u00f9 ch\u1ec9 c\u00f3 m\u1ed9t th\u1ea5t.<\/p>\n

          1.4 Ph\u1eabu thu\u1eadt s\u1eeda to\u00e0n b\u1ed9 b\u1ec7nh t\u1ee9 ch\u1ee9ng Fallot<\/h3>\n

          K\u1ef9 thu\u1eadt bao g\u1ed3m c\u00e1c b\u01b0\u1edbc:<\/p>\n

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          • V\u00e1 th\u00f4ng li\u00ean th\u1ea5t (b\u1eb1ng mi\u1ebfng v\u00e1 nh\u00e2n t\u1ea1o ho\u1eb7c b\u1eb1ng m\u00e0ng tim)<\/li>\n
          • M\u1edf r\u1ed9ng \u0111\u01b0\u1eddng ra th\u1ea5t ph\u1ea3i (c\u1eaft d\u1ea3i c\u01a1 ph\u00ec \u0111\u1ea1i, m\u1edf r\u1ed9ng \u0110RTP b\u1eb1ng mi\u1ebfng v\u00e1 qua van ho\u1eb7c kh\u00f4ng qua van; m\u1edf r\u1ed9ng th\u00e2n nh\u00e1nh \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i k\u00e8m c\u00f3\/kh\u00f4ng t\u1ea1o h\u00ecnh van \u0110M ph\u1ed5i ho\u1eb7c s\u1eed d\u1ee5ng van \u0111\u1ed3ng lo\u00e0i (homograft); l\u00e0m \u1ed1ng van nh\u00e2n t\u1ea1o n\u1ed1i th\u1ea5t ph\u1ea3i v\u1edbi \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i).<\/li>\n<\/ul>\n

            \"D\u1ecb<\/p>\n

            T\u1ed5n th\u01b0\u01a1ng t\u1ee9 ch\u1ee9ng Fallot<\/strong><\/p>\n

            1.5 Ph\u1eabu thu\u1eadt Ross<\/h3>\n

            L\u00e0 ph\u1eabu thu\u1eadt d\u00f9ng van \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i thay th\u1ebf cho van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7.<\/p>\n

            Th\u01b0\u1eddng ch\u1ec9 \u0111\u1ecbnh trong tr\u01b0\u1eddng h\u1ee3p c\u1ea7n thay van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 <\/strong>\u1edf tr\u1ebb nh\u1ecf ho\u1eb7c \u1edf ph\u1ee5 n\u1eef tr\u1ebb.<\/p>\n

            K \u1ef9 thu\u1eadt:<\/p>\n

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            • Van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u0111\u01b0\u1ee3c c\u1eaft b\u1ecf sau khi c\u1eaft r\u1eddi hai l\u1ed7 v\u00e0nh<\/li>\n
            • Van \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i c\u1ee7a ch\u00ednh b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c c\u1eaft r\u1eddi v\u00e0 \u0111\u1eb7t v\u00e0o v\u1ecb tr\u00ed van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, sau \u0111\u00f3 c\u1eafm l\u1ea1i hai l\u1ed7 v\u00e0nh.<\/li>\n
            • Van \u0111\u1ed3ng lo\u00e0i (homograft) ho\u1eb7c \u1ed1ng m\u1ea1ch c\u00f3 van \u0111\u01b0\u1ee3c d\u00f9ng thay cho van \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i \u0111\u00e3 c\u1eaft r\u1eddi.<\/li>\n<\/ul>\n

              1.6 Ph\u1eabu thu\u1eadt h\u1eb9p eo \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/h3>\n

              C\u00e1c ph\u01b0\u01a1ng ph\u00e1p ph\u0201u thu\u1eadt trong b\u1ec7nh l\u00fd h\u1eb9p eo \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 bao g\u1ed3m: S\u1eed d\u1ee5ng v\u1ea1t \u0111\u1ed9ng m\u1ea1ch d\u01b0\u1edbi \u0111\u00f2n \u0111\u1ec3 m\u1edf r\u1ed9ng ch\u1ed7 h\u1eb9p.<\/p>\n

              S\u1eed d\u1ee5ng mi\u1ebfng v\u00e1 \u0111\u1ec3 m\u1edf r\u1ed9ng ch\u1ed7 h\u1eb9p. C\u1eaft ch\u1ed7 h\u1eb9p n\u1ed1i \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 t\u1eadn – t\u1eadn.<\/p>\n

              C\u1eaft ch\u1ed7 h\u1eb9p thay b\u1eb1ng \u0111o\u1ea1n m\u1ea1ch nh\u00e2n t\u1ea1o.<\/p>\n

              B\u1eafc c\u1ea7u qua ch\u1ed7 h\u1eb9p b\u1eb1ng \u0111o\u1ea1n m\u1ea1ch nh\u00e2n t\u1ea1o t\u1eeb \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00ean \u0111\u1ebfn \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 xu\u1ed1ng (h\u1eb9p eo \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u1edf ng\u01b0\u1eddi l\u1edbn).<\/p>\n

              1.7 Ph\u1eabu thu\u1eadt Mustard\/Senning (ph\u1eabu thu\u1eadt \u0111\u1ea3o t\u1ea7ng nh\u0129)<\/h3>\n

              L\u00e0 ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong tr\u01b0\u1eddng h\u1ee3p \u0111\u1ea3o g\u1ed1c \u0111\u1ed9ng m\u1ea1ch <\/strong>. M\u1ee5c \u0111\u00edch c\u1ee7a ph\u0201u thu\u1eadt n\u00e0y l\u00e0 ph\u00e2n l\u01b0u d\u00f2ng m\u00e1u trong hai nh\u0129 <\/em>, m\u00e1u gi\u00e0u oxy t\u1eeb nh\u0129 tr\u00e1i s\u1ebd \u0111\u01b0\u1ee3c chuy\u1ec3n v\u1ec1 th\u1ea5t ph\u1ea3i l\u00ean \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, m\u00e1u ngh\u00e8o oxy t\u1eeb nh\u0129 ph\u1ea3i \u0111\u01b0\u1ee3c chuy\u1ec3n v\u1ec1 th\u1ea5t tr\u00e1i l\u00ean \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i. Nh\u01b0 v\u1eady ph\u0201u thu\u1eadt n\u00e0y s\u1eeda ch\u1eefa v\u1ec1 m\u1eb7t sinh l\u00fd h\u1ecdc, kh\u00f4ng s\u1eeda ch\u1eefa ho\u00e0n to\u00e0n v\u1ec1 m\u1eb7t gi\u1ea3i ph\u0201u h\u1ecdc. Trong \u0111\u00f3 th\u1ea5t ph\u1ea3i s\u1ebd \u0111\u1ea3m nhi\u1ec7m l\u00e0 th\u1ea5t h\u1ec7 th\u1ed1ng c\u00f2n th\u1ea5t tr\u00e1i \u0111\u1ea3m nhi\u1ec7m vai tr\u00f2 b\u01a1m m\u00e1u l\u00ean ph\u1ed5i.<\/p>\n

              Ph\u0201u thu\u1eadt n\u00e0y hi\u1ec7n nay r\u1ea5t \u00edt \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111\u1ea3o g\u1ed1c \u0111\u1ed9ng m\u1ea1ch \u0111\u01a1n thu\u1ea7n (\u0111\u1ea3o g\u1ed1c \u0111\u1ed9ng m\u1ea1ch ho\u00e0n to\u00e0n) v\u00ec li\u00ean quan \u0111\u1ebfn nh\u1eefng bi\u1ebfn ch\u1ee9ng r\u1ed1i lo\u1ea1n nh\u1ecbp, t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng ph\u00e2n l\u01b0u v\u00e0 suy th\u1ea5t ph\u1ea3i, h\u1edf van ba l\u00e1 do \u0111\u1ea3m nhi\u1ec7m vai tr\u00f2 th\u1ea5t h\u1ec7 th\u1ed1ng v\u1edbi s\u1ee9c c\u1ea3n h\u1ec7 th\u1ed1ng l\u1edbn.<\/p>\n

              Tuy nhi\u00ean, ph\u0201u thu\u1eadt n\u00e0y v\u0201n \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng \u0111\u1ed1i v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n \u0111\u1ea3o g\u1ed1c \u0111\u1ed9ng m\u1ea1ch c\u00f3 s\u1eeda ch\u1eefa , bao g\u1ed3m ph\u0201u thu\u1eadt \u0111\u1ea3o c\u1ea3 t\u1ea7ng nh\u0129 v\u00e0 t\u1ea7ng \u0111\u1ed9ng m\u1ea1ch nh\u1eb1m s\u1eeda ch\u1eefa v\u1ec1 c\u1ea3 m\u1eb7t sinh l\u00fd v\u00e0 gi\u1ea3i ph\u0201u cho b\u1ec7nh l\u00fd n\u00e0y.<\/p>\n

              1.8 Ph\u1eabu thu\u1eadt \u0111\u1ea3o t\u1ea7ng \u0111\u1ed9ng m\u1ea1ch (ph\u1eabu thu\u1eadt Jatene)<\/h3>\n

              Ph\u0201u thu\u1eadt n\u00e0y \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho b\u1ec7nh nh\u00e2n \u0111\u1ea3o g\u1ed1c \u0111\u1ed9ng m\u1ea1ch, thay th\u1ebf cho ph\u0201u thu\u1eadt \u0111\u1ea3o t\u1ea7ng nh\u0129. M\u00e1u \u0111\u01b0\u1ee3c chuy\u1ec3n h\u01b0\u1edbng \u1edf t\u1ea7ng \u0111\u1ed9ng m\u1ea1ch l\u1edbn b\u1eb1ng c\u00e1ch \u0111\u1ea3o v\u1ecb tr\u00ed \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i v\u00e0 c\u1eafm l\u1ea1i \u0111\u1ed9ng m\u1ea1ch v\u00e0nh v\u00e0o v\u1ecb tr\u00ed van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 m\u1edbi. K\u1ebft qu\u1ea3, th\u1ea5t tr\u00e1i h\u00ecnh th\u00e1i tr\u1edf th\u00e0nh t\u00e2m th\u1ea5t n\u1eb1m d\u01b0\u1edbi \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 b\u01a1m m\u00e1u v\u00e0o tu\u1ea7n ho\u00e0n h\u1ec7 th\u1ed1ng v\u00e0 nu\u00f4i m\u1ea1ch v\u00e0nh, c\u00f2n th\u1ea5t ph\u1ea3i h\u00ecnh th\u00e1i tr\u1edf th\u00e0nh t\u00e2m th\u1ea5t n\u1eb1m d\u01b0\u1edbi \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i b\u01a1m m\u00e1u cho tu\u1ea7n ho\u00e0n ph\u1ed5i gi\u1ed1ng nh\u01b0 sinh l\u00fd gi\u1ea3i ph\u0201u b\u00ecnh th\u01b0\u1eddng.<\/p>\n

              1.9 Ph\u1eabu thu\u1eadt Rastelli<\/h3>\n

              Ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/p>\n

              V\u1ec1 m\u1eb7t kinh \u0111i\u1ec3n, ph\u0201u thu\u1eadt n\u00e0y \u00e1p d\u1ee5ng v\u1edbi b\u1ec7nh nh\u00e2n \u0111\u1ea3o g\u1ed1c \u0111\u1ed9ng m\u1ea1ch c\u00f3 th\u00f4ng li\u00ean th\u1ea5t v\u00e0 h\u1eb9p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i ho\u1eb7c h\u1eb9p d\u01b0\u1edbi van \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i.<\/p>\n

              C\u00e1c tr\u01b0\u1eddng h\u1ee3p tim b\u1ea9m sinh ph\u1ee9c t\u1ea1p kh\u00e1c nh\u01b0 teo t\u1ecbt van \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i k\u00e8m th\u00f4ng li\u00ean th\u1ea5t (APSO) <\/em>, th\u1ea5t ph\u1ea3i hai \u0111\u01b0\u1eddng ra <\/em>, th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch <\/em>.<\/p>\n

              K\u1ef9 thu\u1eadt g\u1ed3m hai ph\u1ea7n:<\/p>\n

                \n
              • T\u1ea1o \u0111\u01b0\u1eddng h\u1ea7m t\u1eeb l \u1ed7 th\u00f4ng li\u00ean th\u1ea5t l\u00ean \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b \u1eb1ng mi\u1ebfng v\u00e1 nh\u00e2n t\u1ea1o.<\/li>\n
              • M\u00e1u t\u1eeb th\u1ea5t ph\u1ea3i l\u00ean \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i b\u1eb1ng c\u1ea7u n\u1ed1i <\/em>c\u00f3 van (homograft ho\u1eb7c \u1ed1ng m\u1ea1ch c\u00f3 van) \u0111i t\u1eeb th\u1ea5t ph\u1ea3i l\u00ean \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

                Ph\u1eabu thu\u1eadt tim b\u1ea9m sinh \u1edf tu\u1ed5i thanh thi\u1ebfu ni\u00ean v\u00e0 ng\u01b0\u1eddi l\u1edbn n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1ea1i c\u00e1c trung t\u00e2m chuy\u00ean v\u1ec1 tim b\u1ea9m sinh \u1edf ng\u01b0\u1eddi l\u1edbn. T\u1ea5t c\u1ea3 c\u00e1c ph\u1eabu thu\u1eadt tim b\u1ea9m sinh c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c h\u1ed9i ch\u1ea9n gi\u1eefa c\u00e1c b\u00e1c s\u0129 ph\u1eabu thu\u1eadt, b\u00e1c s\u0129 g\u00e2y m\u00ea tim, b\u00e1c s\u0129 […]<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"\nPh\u1eabu thu\u1eadt tim b\u1ea9m sinh - Vinmec<\/title>\n<meta name=\"description\" content=\"Ph\u1eabu thu\u1eadt tim b\u1ea9m sinh \u1edf tu\u1ed5i thanh thi\u1ebfu ni\u00ean v\u00e0 ng\u01b0\u1eddi l\u1edbn n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1ea1i c\u00e1c trung t\u00e2m chuy\u00ean v\u1ec1 tim b\u1ea9m sinh \u1edf ng\u01b0\u1eddi l\u1edbn.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ph\u1eabu thu\u1eadt tim b\u1ea9m sinh - 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