心脏跳动中双腔右心室的外科治疗

SURGICAL MANAGEMENT OF DOUBLE-CHAMBERED RIGHT VENTRICLE UNDER BEATING HEART

目的 :总结心脏跳动中双腔右心室 (DCRV)的外科治疗经验。方法 :31例 DCRV患者接受了该手术 ,术中不阻断升主动脉 ,不灌注心脏停跳液 ,心脏缓慢空跳 40～ 5 0次 /min,鼻温控制在 31～ 35℃之间。结果 :2 2 (71% )例发生完全性右束支传导阻滞 (RBBB) ,全组无手术死亡 ,无低心排综合征 (L OS)、残余室间隔缺损、残余右室内狭窄、 度房室传导阻滞( °AVB)三尖瓣关闭不全 (TI)等并发症。结论 :心脏跳动中行 DCRV的外科治疗 ,心肌无缺血缺氧再灌注损伤 ,对减少和预防 L OS、残余室间隔缺损、残余右室内狭窄、 °AVB、 TI等并发症有积极临床意义。

Objective:To review the experience in surgical management of double chambered right ventricle (DCRV) under beating heart Methods:31 Patients were done by this operation,the patients were kept up unblocking aorta,unfilling cardiac arrest perfusion,bradycardia of 40~50 times/min,hose temperature of 31~35℃during the operation Results:There were no deaths,and on low cardiac output syndrome(LOS),Ⅲ°auriculo ventricular (Ⅲ°AVB),residual ventricular septal defect,redsidal right ventricular outflow tract obstruction and tricuspid valve incompetence(TI),22(71%) right bundle branch block were observed Conclusion:Surgical management of DCRV under beating heart,not only avoid damage of myocardial ischemia,myocardial hypoxia and reperfusion injury but also reduce and prevent complication such as LOS,Ⅲ°AVB,TI residual ventricular septal defect and residual right ventricular outflow tract obstruction