改良Bjork手术治疗三尖瓣闭锁的近—中期结果

The Early and Midterm Results of Modified Bjork Procedure for Tricuspid Atresia

目的：评判改良Ｂｊｏｒｋ手术的术后效果。方法：将１０例接受改良Ｂｊｏｒｋ手术的三尖瓣闭锁患儿与同期接受其它房坦（Ｆｏｎｔａｎ）手术的７例三尖瓣闭锁患儿进行比较。结果：改良Ｂｊｏｒｋ手术后患儿中心静脉压低、胸腔渗液量少；术后２～２４个月复查超声心动图，发现残存的右心室腔有所增大、心肌收缩功能改善、同种瓣叶有抗反流作用。结论：应用同种带瓣血管片做前壁的右心房—右心室连接，同种瓣叶有一定的抗反流作用，右心室有一定的收缩功能，且可望房室连接通道能随年龄增长而扩大。

Objective:To determine the results of the patients who had undergone the modified Bjork procedure. Methods:Ten patients who underwent the modified Bjork procedure and 7 patients who underwent other modified Fontan procedures were compared. Results:The patients who underwent the modified Bjork procedure had better outcome with lower right atrial pressure,less pleural effusion.And the quantitative two dimensional echocardiography study up to 2 24 months after the operation showed that the right ventricular cavity were larger and had the potential of becoming a functioning ventricle.In addition,the homopulmonary valves were in function with no pressure gradient or regurgitation. Conclusions:If the split cryopreserved valved pulmonary artery patch is used as the anterior wall of the right atrium to right ventricule communication,the tunnel will grow with age and the valve of the homograft and the hypoplastic right ventricle will be in function.