先天性左心室憩室

Surgical Treatment of Congenital Left Ventricular Diverticulum and Associated Cardiac Anomalies

总结４例先天性左心室憩室（ＬＶＤ）的外科治疗体会。对２例肌性ＬＶＤ，仅纠治其合并畸形，憩室未予切除；在２例纤维性主动脉瓣下憩室中，１例经假性动脉瘤修补憩室，１例行主动脉瓣替换同时关闭憩室开口。结果除１例经假性动脉瘤修补憩室者，因左冠状动脉损伤术中死亡外，其余３例效果良好。结论认为，肌性ＬＶＤ小而收缩功能好，可仅纠治合并畸形，憩室不予处理；

Aim:This study reviewed the experience of surgical treatment of congenital left ventricular diverticulum (LVD).Clinical material and method:Four patients with LVD were treated surgically.In 2 patients with muscular LVD,only the associated ruptured aneurysm of aortic sinus(and ventricular septal defect in another)and atrial septal defect in 1 case were corrected without repair of LVD.In 2 patients with subaortic fibrous LVD,the diverticulum was repaired through a pseudoaneurysm in 1 patient and closure of the diverticulum with aortic valve replacement was performed in another.Result:One patient died during operation because of left coronary artery injury.The other 3 patients recovered uneventfully.Conclusion:The simple muscular LVD may not require surgery if it is small with well preserved cardiac contractility.But,the important associated cardiac anomaly should be corrected.The transaortic repair of subaortic fibrous LVD is a safe and reliable approach.