房水平单向活瓣式补片在先天性心脏病并发重度肺动脉高压术中的应用

Application of one-way valved patch in surgical treatment of patients with congenital heart disease with severe pulmonary arterial hypertension

目的:探讨并发重度肺动脉高压的先天性心脏病患者的外科手术方式。方法:采用房水平单向活瓣补片对48例本病患者进行手术治疗。其中,室间隔缺损30例,房间隔缺损3例,室间隔缺损并发房间隔缺损8例,室间隔缺损伴动脉导管未闭7例。结果:术后1例(2%)死于低心排综合征。术后早期均有明显低氧血症。术后1周仍出现跨单向活瓣补片分流40例,术后3个月活瓣仍开放10例,术后26个月提示活瓣均关闭,分流消失,经皮血氧均为95%以上,肺动脉压均明显下降。结论:房水平单向活瓣式补片治疗先天性心脏病并发肺动脉高压,使患者度过术后危险期,提高手术成功率。

AIM： To study the surgical treatment of patients with congenital heart disease （CHD） with severe pulmonary hypertension （PH）. METHODS： One-way valved patch was used during surgical treatment for 48 patients with CHD with PH. Patients included represented 30 cases of ventricular septal defect （VSD） , three cases of atrial septal defect （ASD）, eight cases of ~SD with ASD, and seven cases of VSD with patent ductus arteriosus （PDA）. RESULTS ： One patient died postoperatively due to low cardiac output syndrome. All patients suffered from hypoxia postoperatively. After the first postoperative week, transpatch shunt was observed in 40 patients and after 3 postoperative months, open valves were seen in ten cases. Twenty-six months postoperatively, valves closed and shunting disappeared. Transeutaneous oxygen was 〉 95 % and pulmonary artery pressure decreased significantly. CONCLUSION： Application of one-way valved patch in surgical treatment of congenital heart disease with pulmonary hypertension enhances the rate of successful surgeries and more rapid recovery.