三房心的诊断与外科治疗

THE DIAGNOSIS AND SURGICAL TREATMENT OF COR TRIATRIATUM

本文报道手术治疗三房心4例,其中3例伴有房间隔缺损,1例同时合并室间隔缺损。其临床表现为胸闷及心功能减退。超声心动图发现左房内有异常隔膜回声。心血管造影可见左房内有斜行负性显影。3例经右房切口通过房缺或扩大房缺切除异常隔膜,并修补房缺与室缺。1例无房缺者经房间沟切开左房后切除异常隔膜。其中3例存活,1例伴重度肺动脉高压者术后因不可逆性的低心排综合征而死亡。作者认为超声心动图与心血管造影有确诊意义。通常选择右房途径通过房隔切除异常隔膜,如有合并畸形应同时纠治。

Four cases of cor triatriatum were operated on from Sept 1988 to Sept 1989.One case was accompanied with both ASD and VSD,and two with ASD only.The major clinical presentation was deterioration of heart function and the main pathological change in cor triatriatum was abnormal membrane in the left atrium.Echocardiography and cine-angiogr(?)phy may reveal the abnormal membrane in the left atrium.The abnormal diaphragm was excised completely through right(3 cases)or left(1 case)atrium under cardiopulmonary bypass. Postoperative results were 3 patients rehabilitated and 1 patient with severe pulmonary hypertension died of low cardiac output syndrome.The corrective operation through right atrium approach is recommended and correction of accompanying anomalies should be under(?) taken at the same time.