完全性房室隔缺损的外科治疗

Surgical Treatment of Complete Atrioventricular Defect

目的回顾性总结手术纠治４５例完全性房室隔缺损（ｃｏｍｐｌｅｔｅａｔｒｉｏｖｅｎｔｒｉｃｕｌａｒｄｅｆｅｃｔ，ＣＡＶＤ），以期把握好手术时机，提高手术成功率和生存质量。方法根据Ｒａｓｔｅｌｉ分型：Ａ型２６例，Ｂ型２例，Ｃ型２例，过渡型１５例。手术采用单片心包补片修补方法。结果手术死亡３例，死亡率６．７％。死亡原因为伴发心内严重畸形法洛四联症２例，重度肺动脉高压１例；远期死亡２例，均为二尖瓣反流并发肺部感染和心力衰竭。结论ＣＡＶＤ早期出现肺动脉高压，手术应在６个月～１岁内为好，术后必须定期随访。

Objective To provide an overview of surgical treatment of 45 patients with complete atrioventricular defect (CAVD),which is in order to select opportunity for operation and increase surgical success and survival. Methods According to the Rastelli classification:26 patients were type A, 2 patients were type B and 2 patients were type C,15 patients were transitional type. The single pericardium patch was used to repair. Results Three patients died and the mortality was 6.7%. The reason was CAVD with tetralogy of Fallot in 2 and severe pulmonary hypertension in 1. Two patients died lately because of mitral valve regurgitation, pulmonary infection and heart failure. Conclusion The pulmonary hypertension was appeared early in CAVD, the best operative age was from 6 months to 1 year. The patient must be followed up periodically to find atrioventricular regurgitation as early as possible.