右室乳头肌切断及隔瓣切开再缝合的实验研究和临床意义

Experiment and clinical significances of papillary my-otomy’s and septal valvotomy’s resuture in the rightventricle

作者为探讨修复成形术治疗创伤性右室前乳头肌断裂和采用经隔瓣切开或圆锥乳头肌切断术径路修补室间隔缺损（ＶＳＤ）的可行性和效果问题，用实验狗１９只，随机分为四组，分别对右室前乳头肌的血供、切断后复位吻合处的愈合过程、负重耐力及功能状态等进行观察。结果证实，创伤性右室前乳头肌断裂，早期及时作修复成形术可获得良好效果。临床对３１例ＶＳＤ伴隔瓣囊窝改变（ｐｏｕｃｈ）患者手术的结果亦证明，经此径路手术效果与动物实验结果相一致，ＶＳＤ冶愈率达１００％。提示本方法值得推荐临床应用。

AbstractIn this paper,the results of the papillary myotomy and septal tricuspid valvotomy were studied.The19 dogs were randomly divided into four groups so asto observe the blood supply,healing course,strengthand functions of the anterior papillary muscle。 It wasconfirmed that the traumatic rupture of the papillarymuscle should be repaired early. In the clinic 31 patients of ventricular septal defect with tricuspid valvepouch were treated by the approach with septal valvotomy and cone papillary myotomy of tricuspid valve.The successful rate of VSD repair was up to 100%.Therefore,this approach is worthy to be used clinically.