主动脉瓣下狭窄的外科治疗

SURGICAL TREATMENT OF SUBAORTIC STENOSIS

目的探讨先天性主动脉瓣下狭窄手术治疗的方法。方法8例病人均在低温体外循环下进行手术。7例为主动脉瓣下隔膜切除，1例合并左室流出道狭窄，同时行肥厚肌肉切除。4例动脉导管未闭经肺动脉缝闭导管。2例室间隔缺损经右心房直接缝合。结果手术顺利。术后心前区杂音基本消失，症状明显改善出院。随访4～24月，疗效满意。结论主动脉瓣下狭窄的病理解剖变异性大，应按不同类型的病理解剖特征选择手术方法。

Objective To explore the surgical treatments for congenital subaortic stenosis(SAS). Methods8 patients with extracorporeal circulation received operation in low temperature. Subaortic diaphragm was excised in 7 cases and the thickening muscle was excised in the other case with combined outflow tract stenosis of left ventricle. The ducts were sutured through pulmonary artery in 4 cases of patent ductus arteriosus (PDA) and 2 cases of ventricular septal defect (VSD) were sutured right through the right atrium simultaneously with the operation being unevenful. Results The precordial murmurs disappeared and symptoms significantly improved in all cases postoperatively. 4 to 24 months follow-up survey showed satisfactory results. Conclusion The reSults of this study demonstrated that it is very important to choose appropriate surgical procedure for different types of SAS.