摘要
目的探讨法洛四联症合并完全房室间隔缺损(TOFAVSD)心内矫治的手术方法和效果。方法1985年1月至2004年10月,TOFAVSD心内矫治术16例中男7例,女9例;年龄2～16岁,平均(8.1±3.8)岁。采用右房、右心室纵切口,前7例采用3块补片;后9例用2块补片修复房室间隔缺损,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9例死亡1例。死因为严重低心排血量综合征3例,灌注肺1例。8例随访2个月至13.5年。心功能I或II级,无临床症状。结论采用右房、右心室纵切口,2块补片修复房室间隔缺损,常规间断缝合左侧房室瓣裂隙,跨瓣补片加宽右室流出道可取得较良好的疗效。
Objective To discuss the surgical technique in correction of tetralogy of FaUot with complete atrioventricular septal defect （TOF-AVSD）. Methods 16 patients aged 2-16 years underwent correction of TOF-AVSD. The atrioventricular septal defect was closed through a right atriotomy and lengitudinal right ventriculotony in each case. The three - patch technique was used for the first 7 cases and two-patch technique for the later 9 cases. The commissure between the superior and inferior bridging leaflets of the left portion of the common atrioventricular valve was closed in each patient. RVOT obstruction was relieved by a transaunular patch. Results Results There were 4 deaths in the early postoperative period, 3 deaths in the first 7 cases compared to 1 death in the later 9 eases （P〈0.05）. The causes of death included revere low cardiac output syndrome （3 cases） and perfusien pulmonary edema （1 case）. 6 survivors were followed up from 2 months to 13.5 years. Heart function （NYHA） was class 1 or 11 in all eases. Conclusion TOF-AVSD can be corrected 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 eommissure of the left portion of the atrioventricular valve may result in a low incidence of regurgitation.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2005年第4期214-216,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
