改良Bjork手术治疗三尖瓣闭锁12例

THE TREATMENT OF 12 CHILDREN WITH TRICUSPID ATRESIA BY MODIFIED BJORK PROCEDURE

目的：观察改良Bjork手术治疗三尖瓣闭锁的效果。方法自1996年3月至1999年6月，对12例三尖瓣闭锁患儿实施了改良Bjork手术，即应用剖开的带瓣肺动脉片作前壁的右房右室连接术。结果术后患儿中心静脉压（CVP）低、胸液量少；术后血流动力学监测肺动脉为搏动性血流；超声心动图发现残存的右心空腔有收缩功能、右室腔有所增大、同种瓣叶有一定的抗反流作用。结论改良Bjord手术，术后同种瓣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及右心室腔能随年龄增长而扩大。

Objective To determine the results of the patients who had been performed the modified Bjork procedure. Method 12 children with tricuspid atresia underwent the modified Bjork procedure: atrinventricular connection with a flap of valved pulmonary homograft. Results The patients had got better outcome with lower right atrial pressure, less pleural effusion. And the quantitative twodimensional ochocardiography studies showed that the right ventricular cavity were larger and had the potential to be a functional cavity, In addition, the homopulmonary valves were in function and had no pressure gradient or regurgitation. Conclutions If the split cryopreserved valved pulmonary artery patch were used as the anterior wall of the RA to RV communication, the tunnel would be growing and the valve of the homograft and the hypoplastic right ventricle would be on function.