摘要
目的 总结 40岁以上继发孔型房间隔缺损 (房缺 )手术治疗的经验。方法 46例 40岁以上继发孔型房间隔缺损病人 ,年龄 40～ 6 2岁 ,平均 (45 7± 4 4)岁。合并三尖瓣关闭不全 35例 ,其中中度以上关闭不全 2 2例 ;合并二尖瓣关闭不全 10例 ;房颤 6例 ,房扑 2例 ;术前肺动脉测压 2 7例 ,肺动脉平均压为 (35 7± 16 7)mmHg,肺动脉平均压最高为 6 3mmHg。房缺修补采用直接连续缝合和心包片或涤纶补片修补 ,同期行三尖瓣成形术 2 2例 ,其中 10例行Kay二叶瓣成形术 ,12例行DeVega成形术 ;二尖瓣成形术 4例 ,行二尖瓣置换术 2例 ,3例合并有房颤病人同期行右房迷宫术。结果 46例病人术后全部生存 ,心功能均有明显改善。结论 年龄因素不是房缺手术的禁忌证 。
Objective To reviewe the clinical experience in surgical treatment of isolated secundum atrial septal defect (ASD) in elder patients. Method 46 patients over 40 years old (range,40～62,with a mean age of 45 7 years) underwent surgical repair for secundum ASD. Concomitant cardiac anomalys,included moderate to severe tricuspid regurgitation in 22 patients,mitral valve regurgitation in 10,atrial fibrillation in 6 and atrial flutter in 2. Preoperative mean pulmonary artery pressure in 27 patients was (35 7±16 7) mm Hg. All of the patients underwent direct suture closure or Dacron and Pericardia patch. 22 patients underwent either DeVega or Kay tricuspid annuloplasty for TVR,and 4,mitral valve repair and 2,mitral valve replacements. 3 patients with atrial fibrillation underwent right sided maze procedure. All patient survived after surgery. Cardiac function were improved in most of the patients after operation. Conclusion Age is not an absolute contradiction to repair of atrial septal defect. Proper surgical management of the co existing cardiac anomalys is an important factor influencing surgical outcome.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2000年第1期13-15,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
房间隔缺损
孔型
外科手术
继发性
Secundum atrial septal defect Tricuspid regurgitation Surgical treatment
