右室流出道重建术治疗法洛四联症的临床观察

Effects of right ventricular outflow tract reconstruction with modified autologous pericardial monocuspid valve in patients with tetralogy of Fallot:a clinical research

目的评价带瓣心包补片重建右室流出道术在预防法洛四联症术后肺动脉返流中的作用。方法 2001年1月—2004年1月法洛氏四联症患者20例,接受带瓣心包补片重建右室流出道术,术中用心包片扩大右室流出道的同时,将心包片上预留部分折叠形成较大人工瓣兜,与加宽的心包片一并缝合。结果术后无死亡,随访至6个月,行心脏彩超检查显示与对照组相比肺动脉返流程度小于对照组。结论人造单瓣的宽度略大于肺动脉瓣环的宽度,使瓣膜片不致过大产生狭窄,且面积足够,能更好地发挥抗返流作用。

Objective To evaluate the application value of right ventricular outflow tract （RVOT） reconstruction with an autologous pericardial monocuspid valve to prevent pulmonary regurgitation after total correction of tetralogy of Fallot （TOF）. Method Twenty patients suffering from TOF with pulmonary artery hypoplasia, 11 males and9 females, aged （8.43 ±3.83）, received surgical total correction with RVOT reconstruction with autologous pericardial monocuspid valve. During the operation, the RVOT was enlarged with the autologous pericardial patch, and a predesigned part of the pericardial patch was folded to form a big artificial valve, which was stitched along with the pericardial patch. Another 20 patients, 12 males and 8 females, aged （8. 47 ± 3.94 ）, underwent traditional RVOT reconstruction with traditional pericardial monocuspid valve patch. Post-operational follow-up was conducted for 6 months. Results No surgical mortality was recorded after operation. The degree of pulmonary valve regurgitation in the research group was less than that in the control group. Conclusion Modified autologous pericardial monocuspid valve can prevent pulmonary regurgitation better.