房室间隔缺损矫治伴人工瓣环植入22例的单中心回顾性队列研究

Twenty-two patients of atrioventricular septal defect repair with prosthetic valve ring implantation:A retrospective cohort study in a single center

目的探索房室间隔缺损矫治伴人工瓣环植入患者的临床特征及其安全性和有效性。方法回顾性收集广东省人民医院2018年1月1日—2020年7月12日期间,诊断为房室间隔缺损并行人工瓣环植入患者的临床资料。最终纳入22例患者,男9例、女13例,年龄35.00(14.10,53.00)岁。其中左侧房室瓣植入人工半环或者全环9例(40.9%),右侧房室瓣植入人工半环或者全环18例(81.8%)。结果中位术后住院时间7.00(6.00,8.80)d,术后机械辅助通气时间11.00(6.25,19.00)h。术后房室瓣中度以上反流2例(9.1%),左右侧各1例。术后残余室间隔缺损1例(4.5%)。中位随访时间152.00(124.00,1030.00)d。随访期间无左室流入道、流出道梗阻,无术后残余房间隔缺损。结论人工瓣环植入对房室间隔缺损患者是安全有效的,可改善患者瓣环结构强度。该操作对瓣环生理发育的影响值得深入研究,更远期的随访结果需要被进一步关注。

Objective To review the characteristics of patients who underwent atrioventricular septal defects(AVSD)repair with prosthetic valve ring implantation in our hospital,and to analyze the safety and effectiveness of this intervention.Methods The clinical data of all patients diagnosed with AVSD who received surgery repair and prosthetic valve ring implantation from January 1,2018 to July 12,2020 in Guangdong Provincial People’s Hospital were collected and analyzed.There were 22 patients with 9 males and 13 females at a median age of 35.00(14.10,53.00)years.There were 9(40.9%)patients with prosthetic half or full rings placed on the left atrioventricular valve and 18(81.8%)patients with prosthetic half or full rings placed on the right atrioventricular valve.Results The median postoperative hospital stay was7.00(6.00,8.80)d,and the postoperative mechanically assisted ventilation time was 11.00(6.25,19.00)h.There were 2(9.1%)patients of moderate or higher postoperative atrioventricular valve regurgitation,1 on the left and 1 on the right.There was one patient(4.5%)of the postoperative residual septal defect.There was no left ventricular inflow or outflow tract obstruction and no postoperative residual atrial septal defect during the follow-up of 152.00(124.00,1030.00)d.Conclusion Implantation of a prosthetic ring is safe and effective in patients with AVSD,and the structural strength of the ring may be improved after the implantation.The physiological development of the AVSD annulus after prosthetic ring implantation and the results of long-term follow-up needs further attention.