改良Carpentier法治疗Ebstein畸形

Modified Carpentier＇ s repair technique in the treatment of Ebstein＇ s Anomaly ： a Clinical Analysis of 18 Cases.

目的 探讨改良Carpentier法治疗Ebstein畸形的疗效与经验.方法 回顾性分析2003年6月至2009年10月本院手术治疗的18例Ebstein心脏畸形患儿的临床资料.18例均予改良Carpentier法手术矫治,在Carpentier法手术矫治的基础上,后瓣叶边缘对合缝在隔瓣叶或前瓣,以加大面积;同期矫治合并畸形.结果 17例存活,1例因术后并发心律失常持续低氧血症而死亡.存活患儿术后心功能Ⅰ级,均痊愈出院,其中1例术后出现Ⅲ°房室传导阻滞,3个月后转窦性心律.存活患儿均获随访,随访时间6～62个月,生长发育正常.结论 运用改良Carpentier法行三尖瓣成形术治疗Ebstein畸形,右心室功能恢复良好,效果满意,保全了右心室心尖至心底部的长度,是目前较为理想的手术方式.

Objective To evaluate the efficacy of surgical treatment of Ebstein＇s anomaly with modified Carpentier＇ s repair technique. Methods We analyzed 18 patients received corrective surgery for Ebstein＇ s anomaly from Jun. 2003 to Oct. 2009 ; All of them treating Ebstein＇ s anomaly with modified Carpentier＇s repair technique, the edge of posterior leaflet was sewed to the edge of anterior leaflet or septal leaflet in favor of enlarging the area of leaflet. Associated heart lesions were corrected at the same time. Results There were one patient died of hypoxemia and arrhythmia. Complete heart block occurred in one patient. Survivors were followed up for 6 months to 62 months. No late death occurred. Conclusions In the Treatment of Ebstein＇ s Anomaly, The modified Carpentier＇ s repair technique that preserving the apex-to-base dimension of the right entriele , is feasible and possesses a good outcome.