低龄婴儿重度主动脉瓣狭窄手术治疗结果分析

Surgical outcomes of severe aortic stenosis in infants

目的分析低龄重度主动脉瓣狭窄婴儿的病变特征及手术治疗结果。方法选择2012年8月至2019年12月于我院行主动脉瓣交界切开术低龄婴儿(年龄≤90 d)28例,其中男22例、女6例,年龄62.00(47.00,82.50)d。分析患者病变特征、手术及随访结果。结果20例(71.43%)患者瓣叶病理为二叶瓣。术前5例(17.86%)患者心力衰竭,2例(7.14%)使用前列腺素。术后呼吸机使用时间25.00(17.00,62.75)h,住ICU时间3.50(2.00,8.50)d,术后住院时间10.00(7.00,16.50)d。延迟恢复(住ICU时间>14 d)4例(14.29%),死亡1例(3.57%)。术后随访55.00(43.25,82.25)个月,随访期间无死亡,4例(14.81%)患者再次入院行手术治疗,其中3例(11.11%)为主动脉瓣重度狭窄、1例(3.70%)为主动脉瓣重度关闭不全。结论低龄重度主动脉瓣狭窄婴儿病情重,术后恢复时间长,需尽早手术,术后随访结果满意。

Objective To analyze the results of surgical treatment of severe aortic stenosis in infants.Methods From August 2012 to December 2019,28 infants undergoing aortic valvuloplasty in our hospital were selected,including 22 males and 6 females,aged 62.00(47.00,82.50)d.The baseline characteristics of the patients,postoperative complications and follow-up results were analyzed.Results Twenty(71.43%)patients had bicuspid aortic valves.Five(17.86%)patients had heart failure and two(7.14%)patients used prostaglandin before surgeries.Postoperative mechanical ventilation time was 25.00(17.00,62.75)h,ICU stay was 3.50(2.00,8.50)d and postoperative hospital stay was 10.00(7.00,16.50)d.Four(14.29%)patients got delayed recovery(ICU stay>14 d).One(3.57%)perioperative death was observed.The follow-up time was 55.00(43.25,82.25)months.No death was found during follow-up.Four(14.81%)patients underwent a second operation,including three(11.11%)patients with severe aortic stenosis,and one(3.70%)patient with severe regurgitation.Conclusion Infants with severe aortic stenosis are seriously ill and have a long postoperative recovery time,requiring early surgery.The postoperative follow-up results are satisfactory.