多发性室间隔缺损修补术—附六例分析

Surgical treatment of m ultiple ventricular septal defects

目的 :探讨多发性室间隔缺损的心脏手术切口选择以及不同的修补方法与传导束损伤的关系。方法 :回顾 1987年 10月至 1996年 12月期间 ,外科治疗左向右分流先心多发性室缺 6例。结果 :死亡 1例 ,心律失常置入永久性埋藏式起搏器 1例 ,余均痊愈。结论 :膜周与小梁部两个缺损并存 ,可分别采用单一补片或两个补片分别修补的方法 ,主要根据两个缺损相邻的距离。低位缺损可由左室切口进行修补 。

Objective:To appraise a logical approach for closure of multiple ventricular septal defects(VSDs) and the relationship between method of repair and damage of conduction bundle.Method:From October 1987to December 1996 .6 children underwent surgical closure of multiple ventricular septal defects. Results:There was one death,a per- manent pacemaker was placed in the other.Conclusion:Multiple,VSDs when one was located in the perimemberanous portion and one was located atthe midtrabecular septum,these could be closed with a single patch or two,based on the distance between the two neighboring defects.L eftventriculotomy could be performed in the presence of low apical tra- becular VSDs,the surgeon must be extremely cautious not to injure the coronary vessels .