完全型房室间隔缺损的外科治疗

Surgical treatment of complete atrioventricular septal defect

目的 总结完全型房室间隔缺损外科治疗的经验。方法 16例完全性房室间隔缺损患儿,平均年龄(1.2±0 .9)岁,平均体重(6.8±3 )kg。其中10例伴有Down综合征,1例合并法洛四联征。术前超声心动图显示房室瓣轻度反流12例,中度反流3例,重度反流1例。行单片法修补10例,双片法修补6例。结果 术后恢复顺利,无围手术期死亡。除1例患儿于出院4个月后因肺部感染合并心衰死亡外,余随访0 .3～5 .2年,经超声心动图检查显示房室瓣功能良好,未见明显反流。结论 完全型房室间隔缺损患者早诊断,早手术,可获良好疗效。

Objective To summarize the experience of surgical treatment of complete atrioventricular septal defect (CAVSD).Methods From Feb.1995 to Sept.2002,16 patients (9 males,7 females) with CAVSD underwent primary surgical repair with an average age of(1.2±0.9)years and an average weight of(6.8±3) kg.Twelve patients had Down's syndrome and one patient was associated with tetralogy of Fallot.Preoperative echocardiographic atrioventricular (AV) valve regurgitation was mild in 12,moderate in 3,and severe in 1.The septal defects were closed in 10 patients with one-patch method and in 6 patients with two-patch method using different patch materials (autologous or heterologous pericardium,Dacron).Results There was one death because of pulmonary infection associated with heart failure 4 months after discharge.The remaining patients recovered unevenly with a follow-up time of 0.3 to 5.2 years.The postoperative echocardiography showed competent AV valve without significant regurgitation.No associated complications such as pulmonary hypertension,heart failure,low cardiac output syndrome etc occurred.Conclusion Early diagnosis and early primary repair are very important for the prognosis of patients with CAVSD.