改良Carpentier方法矫治Ebstein畸形

Surgical Treatment of Ebstein's Anomaly with a Modified Carpentier's Repair Technique

目的 探讨改良Carpentier方法矫治Ebstein畸形的疗效。方法 ⑴采用自体心包片加宽前瓣 ,⑵后瓣叶边缘对合缝在隔瓣叶或前瓣 ,以加大面积 ,⑶自制心包片包裹的绦纶环加固瓣环 ,⑷可调式Devega三尖瓣成形。结果 1992 -0 1～ 2 0 0 3 -0 5我院采用改良Carpentier方法矫治Ebstein畸形 3 1例 ,除 1例死于顽固性心衰外 ,余 3 0例治愈出院 ,手术死亡率 3 2 %。术后随访 6个月～ 94个月 ,心功能Ⅰ级 6例 ,Ⅱ级 2 1例 ,Ⅲ级 3例 ,未发现新的心律失常。结论 改良Carpentier方法矫治Ebstein畸形 ,方法新颖实用 ,疗效满意。

Objective To evaluate the efficacy of surgical treatment of Ebstein's anomaly with modified Carpentier's repair technique. Methods ⑴Enlarging the anterior leaflet with a pericardium patch; ⑵The edge of posterior leaflet was sewed to the edge of anterior leaflet or septal leaflet in favor of enlarging the area of leaflet; ⑶Annulus was reinforced with the terylene ring covered with pericardium; ⑷Adjustable Devega's procedure. Results 31 patients with Ebstein's anomaly underwent modified Carpentier's repair operation from Jan 1992 to May 2003 in our institution. There was one patient died after operation because of a fatal cardiac dysfunction, and no late deaths. During the followed-up period of 6～94 months, all surviving patients had a marked improvement of heart function, and 6 cases were in class I, 21 in class II and 3 in class III. There were no postoperative rhythm disturbances. Conclusion The modified Carpentier's repair technique is feasible and possesses a good outcome.