37例部分型心内膜垫缺损的外科治疗

Surgical treatment of 37 patients with partial endocardial cushion defect

目的 :总结外科治疗部分型心内膜垫缺损的安全性和有效方法。方法 :回顾性分析 37例部分型心内膜垫缺损病例的诊治情况及手术方法与效果 ;所有病例均采用间断缝合修复二尖瓣裂。结果 :37例中除 1例术后发生永久性房室传导阻滞外 ,无手术死亡 ;间断缝合效果确切并能防止二尖瓣瓣膜面积的缩小 ,用自体心包补片或涤纶片超越冠状静脉窦水平缝合修补原发孔房间隔缺损。结论 :外科手术治疗部分型心内膜垫缺损方法可靠 ,疗效满意。防止传导束损伤及恢复二尖瓣功能是手术成功的关键 ,对心脏传导解剖的正确认识和术者丰富的手术经验是手术成功的保证。

Objective:To summarize safety and efficacy of surgical treatment of partial endocardial cushion defect.Methods:The clinical data of 37 patients with partial endocardial cushion defect were analyzed retrospectively.Their mitral valve clefts were repaired with single intermittent suture,and their primary atrial septal defects were mended with autologous epicardium of Dacron patch.Results:There was no perioperative death.Only one subject suffered from the persistent atrioventricular block. Single intermittent suture prevented the reduction of mitral valve area.Conclusion:Surgical intervention is an effective and feasible method for treating partial endocardial cushion defect.The key to the successful surgery is to avoid the damage of conduction system of heart and to rehabilitate the function of mitral valve.