先天性左室流出道狭窄的外科治疗体会

Surgical treatment of congenital left ventricular outflow track obstruction

目的总结31例先天性左室流出道狭窄的诊断、外科治疗中的经验、教训和疗效。方法2002年11月-2006年5月外科治疗先天性左室流出道狭窄患者31例。其中主动脉瓣膜狭窄9例（29%）;主动脉瓣下狭窄21例（67.7%）;主动脉瓣上狭窄1例（3.2%）。有合并畸形者16例（51.6%）,主动脉瓣置换11例（35.5%）。结果全组无死亡病例;随访2-43个月,平均（13.2±6.8）个月,3例患者残留轻度狭窄（9.7%）。结论该病的治疗效果良好。选择合适的手术方式、完全有效的解除梗阻、同期处理合并畸型、加强术后随访是提高先天性LVOTO外科治疗疗效的关键。

Aim To review the experience of diagnosis and surgical repair of congenital left ventricular outflow track obstruction. Methods From November 2002 to May 2007,31 cases underwent operations. Of the 31 cases, there were aortic valve stenosis in 9 cases （29%）, subvalvular stenosis in 21 cases （67.7%）, supravalvular aortic stenosis in 1 case（3.2% ）. Concomitant lesions were in 16 cases, and 11 cases（35.5% ） underwent mechanical aortic valve replacement（AVR）. Results There was no early death. The follow- up was 2 to 43 months （mean 13.2 ± 6.8 months） ,residual mild stenosis in 3 cases. Conclusion This disease has a good surgical outcome. Choosing the appropriate procedure for different types of LVOTO, getting rid of obstruction completely and effectively, correcting associated lesions and careful follow-up were the keys to improving the results of surgical treatment of LVOTO.