摘要
1972年1月至1992年8月治疗继发孔型房间隔缺损合并中度以上二尖瓣关闭不全39例。男10例、女29例,年龄3～50岁。9例二尖瓣前瓣裂隙,用间断缝合修补裂隙、1例前瓣瓣叶穿孔用间断缝合修补,2例前瓣脱垂作了腱索缩短术,39例都作了瓣环折叠术、其中14例作了 Devega手术,25例作后内交界折叠术。1例在成形术后发现仍有明显返流,立即行二尖瓣置换术;然后修补房间隔缺损,其中19例保留0.5cm 直径小孔。术后早期死亡2例,死亡率5.1%,34例获长期随访,时间为4个月至18年11个月,无随访期死亡,32例(94%)心功能明显改善,其中心功能Ⅰ级26例,心功能Ⅱ级6例,仅有1例于10年后因明显二尖瓣返流,而行二尖瓣置换术。
From January,1972 to August,1992,39 patients suffered from ASD associated
with MI underwent surgical treatment.10 of these patients were male and 29 were fe-
male.Ages ranged from 3 to 50 years(mean 21.3±9.5 years).9(23%)of them were
under 15 years old.2 patients were in heart function Ⅰ,16 in Ⅱ,20 in Ⅲ and 1 in
Ⅳ(NYHA)before operation.39 patients who had middle to severe MI were performed
with mitral repair and closure of ASD through cardiopulmonary bypass.9 of them
had anterior leaflet cleft,2 had anterior leaflet prolapse,2 had anterior leaflet light
shrinkage,14 had posterior leaflet light shrinkage and all of the patients had mitral
annulus dilatation.The operating methods included multiple interrupted sutures of leaflet
cleft,shortening plasty of the chordae,annulus plication and commissure plication.One
patient was performed with mitral replacement soon after the result of the mitral repair
was found unsatisfactory.2 paients died in hospital(mortality 5.1%).
34 patients were followed up from 4 months to 18 years and 11 months(mean
105.6±70.7 months).All except one showed remarkable improvement in heart function.
One patient who had remarkable MI in ten years after he underwent mitral repair was
performed with mitral replacement.This results showed that ASD associated with MI
might be satisfactorily treated with repair of MI and closure of ASD.
出处
《上海医学》
CAS
CSCD
北大核心
1993年第11期637-639,共3页
Shanghai Medical Journal
关键词
房间隔缺损
二尖瓣
关闭不全
手术
Secundum atrial septerl defect
Mitral insufficiency
Mitral repair
