先天性室间隔缺损合并主动脉瓣下狭窄10例的外科治疗

Surgical Operation of 10 Cases Combing Congenial Ventricular Septal Defect and Aortric Subvalvuar Stenosis

目的 总结先天性室间隔缺损合并主动脉瓣下狭窄手术治疗经验。方法 对 1995年 12月— 2 0 0 0年 12月收治的先天性室间隔缺损合并主动脉瓣下狭窄 10例 ( 7例为瓣下膜性狭窄 ,3例瓣下肌性圆锥致瓣下狭窄 ) ,根据不同类型狭窄选择不同手术方式 ,在彻底矫治主动脉瓣下狭窄的同时修补好室间隔缺损。结果 该方法提高了手术效果 ,无手术中晚期死亡。所有患者术后复查心脏彩色超声显示 :室缺修补完善 ,主动脉瓣下血流通畅 ,左心室与主动脉峰值压差 <2 0mmHg ,主动脉峰值流速 1.2～ 2 .4/(min·s)。结论 先天性室间隔缺损合并主动脉瓣下狭窄导致的左心室负荷加重 。

Objective To sum up experience of surgical operation for combing congenial ventricular septal defect and aortric subvalvuar stenosis.Methods There were 10 cases who suffered from ventricular septal defect and aortric subvalvuar stenosis and had performed operation,among these patients 7 with subvalvuar membrous stenosis and 3 with stenosis resulting from subaortric myocardium.According to varing subgroup,we should have selected different operative methods, quite rectify malformation of subaortric stenosis and ventricular defect.Results Througt these method,there were good results:perfection of reparing ventricular septal defect,making smooth blood in aortric subvalvuar,shorting pressure max disparity<20mmHg between left ventricular and aortic,increasing max blood speed in aortic >1 .2～2.4/(min·sec).Conclusion It should be operated as possible as eary when left myocardium hypertrophy and overload in left ventricular with quckly varity with pathophsiology.