部分型房室通道的外科矫治  

Surgical treatment of partial atrial ventricular canal

作　　者：侯迈[1] 杨军民[1] 于鲁峰[1] 陈元恒[1] 徐金星[1] 李令珂[1] 

机构地区：[1]空军总医院心胸外科,北京100036

出　　处：《空军总医院学报》2007年第3期147-148,151,共3页Journal of General Hospital of Air Force,PLA

摘　　要：目的探讨不同手术方式矫治部分型房室通道的效果。方法全组36例病人在全麻中低温、体外循环下手术。二尖瓣前叶裂间断缝合,仍有关闭不全的采用双孔二尖瓣成形术,先天的二尖瓣双孔予以保留。原发孔房间隔缺损的下缘缝合,13例位于冠状静脉窦开口后下缘;10例位于冠状窦开口前上缘;另13例缝在二尖瓣前叶的根部。结果全组无手术死亡,人工双孔二尖瓣和保留先天双孔二尖瓣的病人,二尖瓣无反流及狭窄。早年有1例发生完全性房室传导阻滞。结论二尖瓣成形及避免房室传导阻滞的发生是矫治部分型房室通道手术的关键。Objective To evaluate the effect of several operative methods on the correction of partial atrial ventricular canal. Methods 36 patients were operated under the systemic anesthesia and moderate hypothermia with cardiopulmonary bypass. The cleft of mitral anterial leaflet was sutured interruptedly. If the mitral valves remained insufficiency after suture, we adopted double orifice mitral valve repair. The congenital double orifice of mitral valves in two patients were preserved. When the downside of the primary atrial septal defect was sutured, the suture line was posteroinferior to the coronary sinus in 13 patients, anterosuperior to the coronary sinus in 10 patients and in another 13 patients, the suture line at the mitral valve＇s bottom far from the coronary sinus. Results There are no deaths in these patients. No regurgitation or stenosis occurred in the patients with artificial or congenital double orifice mitral valve. Permanent atrioventrieular block happened in 1 ease at early stage. Conclusion Mitral valve repair and prevention of atrioventricular block are the key points for the correction of patial atrial ventricular canal.

关 键 词：心内膜垫缺损/外科学 

分 类 号：R726.12[医药卫生—儿科] R726.541[医药卫生—临床医学]