重度肺动脉瓣狭窄147例外科治疗

Surgical treatment of 147 cases of severe pulmonary valve stenosis

目的总结重度肺动脉瓣狭窄外科治疗的临床经验。方法对147例重度肺动脉瓣狭窄患者在平行体外循环下施行外科手术治疗,其中肺动脉瓣切开术32例,右室流出道跨瓣环心包补片115例。结果全组术后死亡4例,死亡原因为低心排综合症。其余手术顺利,术后恢复良好。结论充分解除右室流出道梗阻,合理加宽肺动脉是手术成功的关键。自体心包补片加宽右室流出道及肺动脉,能有效解决流出道梗阻及肺动脉狭窄,并可预防残余梗阻的发生。

Objective To sum up the clinical experience of 147 cases of severe pulmonary valve stenosis.Methods One hundred and fourty-seven cases of severe pulmonary valve stenosis received radical correction of severe pulmonary valve stenosis,32 cases underwent pulmonary valvotomy,115 cases underwent transannular right ventricular outflow tract with pericardium patch enlargement in.Results There were four postoperative deaths.The causes of death were serious low cardiac output.The operation of the rest was successful,postoperative recovery was well.Conclusion Total relief of obstruction of right ventricular outflow tract and reasonable broadening of pulmonary artery are the key factors of successful operation.Widening right ventricular outflow tract and pulmonary artery with autologous pericardial patch can effectively resolve pulmonary stenosis and obstruction of right ventricular outflow tract in addition to remnant obstruction.