婴幼儿肌部多发室间隔缺损的手术治疗

Surgical Repair of Multiple Muscular Ventricular Septal Defects

目的报告经心房径路再心内膜化技术修补单纯多发室间隔缺损手术和近期随访结果。方法回顾阜外医院从2006年8月至2009年1月间采用体外循环下经心房径路再心内膜化技术行多发室间隔修补术的病例资料和随访资料。结果8个患儿均实施了经右心房径路再心内膜化手术,避免了左心室或者右心室切口。年龄3～27(8.9)m,体重6.3～14.5(9.9)kg。所有的病例均痊愈出院,术后平均Qp∶Qs为1.07∶1。平均随访时间1～19(15)m。1例患儿因出现重度的肺动脉高压重新入院接受肺高压治疗外,其他患儿均恢复良好。所有患儿均没有显著的室缺残余分流。结论心房径路再心内膜化技术修补多发室间隔缺损避免了分期手术,无需心室切口,保存了心室功能,可以取得很好的手术效果。

OBJECTIVE To report surgical outcome and follow - up results of muhiple muscular ventricular septal defects （VSD） using reendocardialization technique. METHODS Retrospectively analyze the admission record and follow - up data of the patients underging reendocardilaization procedure between August 2006 and January 2009. RESULTS 8 patients underwent the operation. The mean age was 8.9 （ 3 - 27 ） months with mean weight of 9.9 （6.3 - 14.5 ） kg. All the VSD were closed by trans -atrial redoeardialization （TAR） technique. All patients recovered well to discharge, with mean Qp： Qs 1.07： 1. Mean follow - up duration was 15 months （ 1 month - 19 month） . Clinic outcome is good in all patients except 1 patient who required to treat his pulmonary hypertension. No significant residual shunt was observed. CONCLUSION TAR is an effective technique to repair multiple muscular ventricular septal defects and to avoid the need of ventricular incision and preserve ventricular function.