嵌合肺动脉瓣成形术在法洛四联症患者重建右心室流出道的应用

Embedding strategy of pulmonary valvuloplasty for reconstruction of right ventricular outflow in tetralogy of Fallot

目的探讨嵌合肺动脉瓣成形术在法洛氏四联症(TOF)手术重建右心室流出道的应用及临床疗效。方法回顾性分析山东大学附属省立医院2011年9月至2016年6月应用嵌合肺动脉瓣成形术重建TOF患者右心室流出道42例患者临床资料。该术式设计梯形补片嵌合入自体肺动脉前瓣,重建肺动脉瓣环,修复瓣叶对合面积不足。随访3~52个月,采用经胸超声心动图评价肺动脉瓣反流程度。结果采用嵌合肺动脉瓣成形术重建右室流出道,近中期临床效果满意,肺动脉瓣反流程度均低于中度。结论对于肺动脉瓣环严重狭窄和肺动脉瓣叶发育不良的TOF患者,嵌合肺动脉瓣成形术有助于改善术后肺动脉瓣反流程度。

Objective To evaluate the effect of embedding strategy of pulmonary valvuloplasty for reconstruction of right ventricular outflowin tetralogy of Fallot. Methods The clinical data of 42 patients treated with this strategy during Sept. 2011 and June 2016 were retrospectively analyzed. During the surgery,the designed trapezoidal patch was inserted into dissected pulmonary valve in order to augment valve cusp and reconstruct valve ring. During the follow-up of3 ~ 52 months,the pulmonary valve regurgitation（ PVR） was evaluated. Results The surgery produced good shortterm and medium-term effects,sustaining moderate PVR. Conclusion For patients with severe stenosis of pulmonary valve ring and dysplasia of pulmonary valve cusp,embedding strategy of pulmonary valve augmentation and annular extension improves PVR.