经室间隔缺损切除主动脉瓣下狭窄(附6例报告)

Resection of Subaortic stenosis through Ventricular Septal Defect——adnexal report of 6 cases

目的探讨手术治疗主动脉瓣下膜性狭窄的手术经路及其效果。方法回顾分析我院2002年3月—2009年3月6例经室间隔缺损切除主动脉瓣下狭窄患者的临床资料。结果本组6例,占同期主动脉瓣下狭窄手术治疗患者(9例)的三分之二,合并室间隔缺损直径8-22mm,无手术死亡和术后心律紊乱、瓣膜损伤及残余狭窄等并发症发生,术后4例心前区杂音消失,2例合并双腔右心室者心前区存在功能性杂音,随访3个月-6年,心功能全部正常。结论对于合并有较大室间隔缺损(8 mm以上)的主动脉瓣下狭窄,采用经室间隔缺损切除狭窄,可缩短体外循环手术时间,避免经主动脉切口可能产生的并发症,获得良好效果。

Objective To study the operative path and effect of surgical treatment of subaortic stenosis from March 2002 to March 2009 in our hospital.Methods Review and analyze the clinical data of six cases in the report.Results There were six patients combined ventricular septal defect（VSD） and subaortic stenosis（Two-third of nine patients who were operated to subaortic stenosis in the same time）,the diameter of combined VSD is 8 mm-22 mm.No complications were happened such as operative death,arrhythmia,valve injury,and residual stenosis.After operation,heart murmur of four patients were disappeared,two patients combined with Double cavity right ventricle（DCRV） exist founctional murmur.Follow up three months to six years,heart function were all normal.Conclusion For the subaortic stenosis combined with larger VSD（8mm or more）,resection of subaortic stenosis through VSD can shorten cardiopulmonary bypass time,avoid complications of aortic incision,and obtain good results.