摘要
目的 探讨房室通道及其并发畸形手术治疗的经验。方法 手术治疗房室通道 36例 ,其中部分性房室通道(PAVC) 2 8例 ,完全性房室通道 (CAVC) 8例 ;并发冠状静脉窦顶膜缺如 4例 ,左上腔残留 3例 ,双孔二尖瓣、继发孔房缺、肺动脉瓣狭窄各 2例 ,动脉导管未闭、右上肺静脉异位引流、三房心、共同心房各 1例。PAVC手术方法采用间断缝合二尖瓣裂缺 ,心包补片关闭原发孔房缺。CAVC采用双片修补法 ,即用Dacron片修补室缺 ,用自体心包片修补原发孔房缺。 2例冠状静脉窦顶膜缺如合并左上腔者术中插管转流 ,术终仍保留冠状静脉窦开口在右房内 ;另外 2例未合并左上腔者经房缺补片将窦口隔入左房侧。另 1例左上腔静脉套带阻断 ,术中定时开放。 1例双孔二尖瓣行瓣裂修补及瓣下结构修理 ;另 1例只须修补瓣裂。并发的其它心脏畸形术中予以同期处理。结果 PAVC手术死亡 1例 ,死因为术后严重心律紊乱 ;CAVC手术无死亡。结论 房室通道一旦诊断明确均应手术治疗 ;妥善修补间隔缺损及瓣膜裂缺 。
Objective To review the experience of surgical procedure for atrioventricular canal defect (AVCD) and combined cardiac abnormality. Methods 36 patients with AVCD underwent surgical repair under extracorporeal circulation. Among them 28 patients had partial atrioventricular canal defect (PAVC) and 8 had complete atrioventricular canal defect (CAVC). In these patients, combined cardiac abnormality included unroofed coronary sinus in 4, super left canal venous in 3, double orifice of mitral valve in 2, seconday atrial septal defect, pulmonary arterial stenosis in 2, persistent ductus arteriosus, super right pulmonary venous anomalous connection in 1, cor triatriatum and common atria in 1. The cleft of mitral valve was sutured interrupted, and the primary atrial septal defect was repaired with pericardial patch. The Dacron patch was used to repair ventricular septal defect. Results In CAVC group, there was no postoperative death. In PAVC group, one patient died of low cardiac outcome postoperative. Conclusion In surgical repair of AVCD, management of canal defect or mitral valve cleft and combined cardiac abnormality is an important operative technique.
出处
《安徽医科大学学报》
CAS
2003年第6期463-465,共3页
Acta Universitatis Medicinalis Anhui
