成人房间隔缺损的手术治疗(附43例报告)

Surgical treatment of isolated atrial septal defect in elder patients

目的 总结成人房间隔缺损 (房缺 )手术治疗经验。方法 43例病人均在全麻常温体外循环下手术 ,采用直接缝闭 2 4例 ,补片修补 19例 ,同期行三尖瓣 Devega成形术 9例 ,二尖瓣置换术 1例。结果 术后 1例因引流液偏多行二次开胸探查术 ,全组病人均痊愈出院。结论 成人房缺一经确诊均应积极手术治疗 ,避免严重肺动脉高压发生 ,围术期的处理是提高手术疗效的关键。

Objective To reviewe the clinical experience in surgical treatment of isolated secundum atrial septal defect(ASD)in elder patients.Methods All patients received the operation under general anesthesia cardiopulmonary bupass,24 patients underwent direct suture closure,19 patients underwent patch,9 patients Devega for tricupid regurgitation,one mitral valve replacement at the samtime.Results Reoperation was performed for one with more drainage at postoperation.All patients recoverd smoothly.Conclusions Surgical closure should be performed at once diagnosis for elder patients of ASD,that was avoied to serious pulmonary hypertension,the proper perioperitive care are important factor to improve operation.