先天性主动脉瓣下狭窄的外科治疗(附6例报告)

SURGICAL TREATMENT ON 6 PATIENTS WITH CONGENITAL SUBAORTIC STENOSIS

1985年7月至1989年10月,作者为6例先天性主动脉瓣下狭窄的病人进行手术治疗。根据病理分型,3例为隔膜型狭窄,3例为隧道型狭窄。其中合并畸形有动脉导管未闭2例,室间隔缺损1例及部分性房室管畸形1例。3例隔膜型狭窄的病人施行纤维膜切除,术后病人无压力阶差;另3例隧道型狭窄者施行肌部分切除术,手术死亡2例,存活的1例病人的压力阶差随术后时间的推延而增加。术后随访1～5年。

Between July 1985 and October 1989, 6 patients with congenital subaotic stenosis were treated surgically. Accrding to the pathological classification, discrete membranous stenosis was present in 3 patients and tunnel stenosis in 3 patients. Associated cardiac anomalies were PDA in 2, VSD 1 and partial A-V canal defect each in 1. Local resections of the fibrous membrance were performed in 3 patients with membranous steinosis. The patients showed no residual pressure gradient postoperatively. Another 3 patients with tunnel stenosis were undergone myectomy. There were two perioperative deaths. The survived patient showed the residual pressure gradient increased with time postoperatively. Postoperative follow-up were available from 1 to 5 years. The pathological characteristics of tunnel stenosis and the selection of operative method were discussed.