改良三尖瓣下移畸形矫治术(附13例)  

Modified methods to treat downward displacement of tricuspid valve:a report of 13 cases

作　　者：马捷[1] 孙宗全[1] 林文杰[2] 李新华[3] 张文凯[3] 闫子星[3] 邓勇志[3] 刘爱军[3] 王玉璇[3] 李强[3] 张毅勋[3] 孙学军[3] 杨丽娜[3] 

机构地区：[1]华中科技大学同济医学院协和医院心血管外科,武汉430022 [2]长治医学院附属和平医院心胸外科 [3]山西医科大学第二临床医学院心胸外科

出　　处：《山西医科大学学报》2007年第5期428-429,共2页Journal of Shanxi Medical University

摘　　要：目的探讨改良三尖瓣下移畸形矫治术的疗效。方法①探查三尖瓣叶情况;②将后叶、隔叶以及前叶近足侧1/3-1/2的部分,沿瓣环根部将瓣叶切下;③纵行折叠房化的右心室;④将切下的瓣叶缝合于正常三尖瓣环上;⑤自体心包加固三尖瓣环;⑥必要时双孔三尖瓣成形减少反流;⑦修补其他畸形。结果患者无围术期死亡,术后均顺利恢复。术后随访1-84个月,患者恢复正常活动,心功能恢复至Ⅰ级者10例,Ⅱ级者3例。结论改良三尖瓣下移畸形矫治术较好地保持了右心室的几何形状,疗效满意。Objective To evaluate the surgical repair efficacy of modified methods on downward displacement of tricuspid valve （DDTV）. Methods ①Tricuspid valve was explored;②The leaflets of tricuspid valve were removed along tricuspid annulus, including posterior leaflet, septal leaflet and 1/3 - 1/2 lateral anterior leaflet; ③Atrialized right ventricle was longitudinally plicated; ④The leaflets were sewn to the normal valve annulus; ⑤The annulus was reinforced with auto-pericardium; ⑥If necessary, doubleorifice technique was used; ⑦The associated anomalies were corrected at same. Results There were no perioperative and late deaths. After follow-up for 1 -84 months, the cardiac function of all surviving patients was markedly improved, including 10 cases in NYHA class Ⅰ and 3 in class Ⅱ. Conclusion The modified repair technique is feasible for keeping the shape of right ventricles of patients with DDTV.

关 键 词：心脏缺损 先天性 心脏外科手术 Carpentier法 “双孔”技术 改良三尖瓣下移畸形矫治术 

分 类 号：R541.1[医药卫生—心血管疾病]