部分性房室管畸形外科治疗及疗效探讨

Evaluation of the Surgical Treatment of Partial Atrioventricular Canal Defect

目的 探讨外科治疗部分性房室管畸形的手术方法及其疗效。 方法 48例部分性房室管畸形患者均在体外循环心内直视术下缝合二尖瓣大瓣裂缺及修补房间隔缺损,其中9例同时行瓣膜成形手术。 结果 术后早期(30天内)死亡2例,死亡率4.17%。发生度房室传导阻滞2例,再次手术4例。术后39例随访3个月～12年,平均随访9年。 结论 经随访,手术后二尖瓣无反流或少量反流者长期疗效良好。

Objective To review the experience of surgical treatment of partial atrioventricular canal defect. Methods Forty eight patients with partial atrioventricular canal defect were surgically treated from Jan.1984 to Dec. 1998. There were 24 males and 24 females with age range from 5 to 50.The cleft of mitral valve presented in whole of those patients, coronary sinus was situated on the left atrium in 4 cases. The ostium prium atrial septal defects were repaired with patches of Dacron in 12 and autologous pericardium in 36 cases. Follow up evaluation were performed in 39 of 46 survivors with a range of 3 months to 12 years(mean follow up 9 years). Results There were two early death(4.17%),one patient died of heart arrhythmia, the second patient died of respiratory failure. Four patients have been re operated for different reasons after the primary operation. Conclusion After operation, if patients have mild regurgitation of mitral valve, they will have good treatment results. Provided those have more than moderate regurgitation of mitral valve, then their long term treatment results will be worse.