新鲜自体心包在心脏手术中应用的经验

The Experience of Using Fresh Autologous Pericardium in Cardiac Operation

目的 :介绍新鲜自体心包在心脏手术中应用的经验。 方法 :我院在 32 1例心脏手术中应用了未经戊二醛处理的新鲜自体心包作为修复材料 ,应用范围广泛 ,包括先天性心脏病、风湿性心脏病和心脏肿瘤。 结果 :术后早期死亡 2 0例 ,手术死亡率 6 .1%。并发症 :1例法乐四联症根治术后室间隔缺损残余漏 ,经二次手术修补治愈出院。3例室间隔缺损修补术后少量残余漏 ,随诊观察。全组 75 .7%的病人获得随诊 ,无术后溶血、栓塞、感染性心内膜炎、补片钙化及心包片瘤样膨出等并发症。 结论 :新鲜自体心包是心脏手术的优良修复材料。

Objective:To introduce the experience of using the fresh autologous pericardium in cardiac operation. Methods:Fresh autologous pericardium unprepared by 0 5% glutardaldehyde was used in cardiac operations in 321 patients.It was used not only in repair of atrial septal defect and ventricular septal defect,but also in operations of many complicated congenital heart diseases,such as tetralogy of Fallot,double outlet of right ventricle,atrioventricular canal,single atrium anomalous pulmonary venous connection,Ebstein's anomaly,tricuspid atresia,pulmonary atresia,single ventricle,complete transposition of the great ateries.Autologous pericardium was also used for enlargement aortic root in rheumatic heart disease and repairing of atrial septium after resection of the left atrial myxoma. Results:Twenty patients (6 1%) died within 30 days after operation.The residual shunt was found in one patient with tetralogy of Fallot and three patients with ventricular septal defect.Two hundred and fourty three patients (75 7%) were followed up.No patient had hemolysis,embolism,infectious endocarditis,patch calciflcation or other complications concerned with the use of the autologous pericardium after operation. Conclusion:The fresh autologous pericardium is a good material for repairing cardiac defects.