心脏房室管畸形的外科治疗

THE SURGICAL TREATMENT OF ATRIOVENTRICULAR CANAL DEFECTS

手术治疗心脏房室管畸形15例,其中单纯型4例、部分型9例、完全型2例。术中先修补二、三尖瓣裂口,后用Dacron补片修补心内膜垫缺损。Koch三角区近三尖瓣隔瓣处间断浅缝合。13例冠状静脉窦口留在右房,2例在左房。术后合并三度房室传导阻滞1例,死亡1例,2次手术及残留分流各1例。13例恢复良好。术后常规应用临时起搏预防传导阻滞。

15 cases of atrioventricular canal defects underwent surgical correction in our hospital. including 4 single ostium primum atrial septal defect, 9 partial atrioventricular canal defect and 2 complete defect. The cleft in mitral valve and tricuspid valve was closed by interrupted stitchs. Dacron patch was used for repairing the defect. Care must be taken in Koch triangle area with shallow stitchs. 13 cases of coronary sinuses were partitioned in right atrium, 2 cases in left atrium. There were a fistual around Dacron patch in one case, and a reoperation in another case. 13 cases recovered well after operation. Tempotary pacing wire was used routinely to prevent block after operation. There were one case who died and 1 third degree A-V block.