经右心室小切口修补心尖肌部室间隔缺损

Surgical Closure of Apical Muscular Ventricular Septal Defect Through Small-incision Right Ventriclar Apical Infundibulotomy

[目的]探讨心尖肌部室间隔缺损（VSD）的解剖学特点,比较不同治疗方法的优缺点,总结经漏斗心尖部右心室小切口修补心尖肌部VSD的经验.[方法]对三例伴有心尖肌部VSD的先心病患儿采用经漏斗心尖部右心室小切口间断缝合涤纶补片关闭心尖肌部VSD并同期矫治伴发先心病.[结果]三例患儿心功能恢复正常,心尖肌部VSD无残余分流.[结论]采用漏斗心尖部右心室小切口修补心尖肌部VSD是简便、有效、可靠的手术方法,尤其适用于婴幼儿和伴有其他心脏畸形的心尖肌部VSD患儿.

[Objective] To explore the anatomic features of apical muscular ventricular septal defect （VSD）, and compare the advantages and disadvantages of different procedures, and summarize the experience of surgical closure of apical muscular VSD through small-incision right ventricular apical infundibulotomy. [Methods] Three cases of congenital heart disease accompanying apical muscular VSD underwent surgical repair in our hospital. The apical muscular VSD was approached through small-incision right ventricular apical infundibulotomy and closed by Dacron patch with the interrupted pledget mattress suture, meanwhile other cardiac malformations were repaired. The relevant literatures were also reviewed. [Results] The result of surgical treatment was satisfying and heart function was in NYHA class I . No residual shunt was found by echocardiogram. [Conclusion] The repair procedure of apical muscular VSD through small-incision right ventricular apical infundibulotomy is a convenient, effective and reliable method, especially suitable for the infant patients and apical muscular VSD children accompanying other cardiac abnoi-malities.