儿童完全性房室通道外科治疗16例

Surgical Treatment of 16 Cases with Complete Atrioveutricular Canal Defect(CAVCD) in Children

１６例完全性房室通道男女各８例，年龄８月～８岁，体重６～２０ｋｇ．中、重度肺高压各６例。ＲａｓｔｅｌｌｉＡ型１４例，Ｂ及Ｃ型各１例。均行外科治疗，早期死亡１例，医院死亡率６％；晚期死亡２例。存活１３例中，１２例（９２．３％）随访２月～４年，恢复情况良好。强调本病须尽早手术治疗、术中牢固修补ＶＳＤ和原发孔ＡＳＤ及恢复二尖瓣功能的重要性。对术后肺高压处理特点进行讨论。

This article reports our experience in surgical treatment of 16 cases with CAVCD.Male and female were equally divided in this group of patients.The age ranged frorn 8 months to 8 years and body weight from 6 to 20kg.Moderate and severe pulmonary hypertension(PH)occurred in 6 cases each.Fourteen cases were classified as Rastelli A,one case Rastclli B and another Rastelli C.There was one early(hospital mortality 6%)and two late operative deaths.Twelve of the 13 survivors(92.3%)were followed up from 2 months to 4 yeare and were all in satisfactory condition.The authors emphasize early operation, firm repair of the VSD and ASD primum and restoration of the function of the mitral valve.The characteristics in management of postoperative PH are also discussed.