摘要
目的 总结心内矫正术治疗完全型房室间隔缺损合并法洛四联症 (CAVSD- TOF)的经验。 方法 从1985年 1月至 2 0 0 2年 5月 ,共行 CAVSD- TOF心内矫正术 12例 ,年龄 6～ 16岁 (11.1± 2 .8岁 ) ,采用右心房、右心室纵切口 ,前 7例采用三片法补片 ,后 5例用二片法补片修补房室间隔缺损 ,左侧房室瓣裂隙采用间断缝合 ,右心室流出道用跨瓣补片加宽。 结果 术后早期死亡 4例 ,前 7例死亡 3例 ,后 5例死亡 1例 ,死亡原因为严重低心排血量 3例 ,灌注肺 1例。长期随访 6例 ,随访时间 3个月至 13.5年 ,无任何症状 ,NYHA心功能 级或 级。 结论 CAVSD- TOF采用右心房、右心室纵切口 ,二片法补片修补房室间隔缺损 ,常规间断缝合左侧房室瓣裂隙 。
Objective To summarize the experience of surgical correction of complete atrioventricular septal defect associated with tetralogy of Fallot(CAVSD-TOF). Methods Twelve patients aged 6-16(11.1±2.8) years underwent correction of CAVSD-TOF. The atrioventricular septal defect was closed through a right atriotomy and longitudinal right ventriculotomy in each case. The three-patch technique was used for the first 7 cases and two-patch technique for the later 5 cases. The commissure between the superior and inferior bridging leaflets of the left portion of the common atrioventricular valve was closed in each patient. Right ventricular outflow tract obstruction was relieved by a transannular patch. Results There were 4 deaths in the early postoperative period, 3 deaths in the first 7 cases compared to 1 death in the later 5 cases. The causes of death included severe low cardiac output syndrome(3 cases) and perfusion pulmonary edema(1 case). Six survivors were followed up from 3 months to 13.5 years. Heart function (NYHA) was class I or Ⅱ in all cases. Conclusion CAVSD-TOF can be corrected by using the two-patch technique and closure of atrioventricular septal defect through a combined approach through right atriotomy and right ventriculotomy. Routine closure of the commissure of the left portion of the atrioventricular valve achieves a low incidence of regurgitation.
出处
《中国胸心血管外科临床杂志》
CAS
2004年第3期168-170,共3页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
