三尖瓣下移畸形的外科治疗(附24例报告)  

Surgical Correction of Ebstein's Anomaly-24 Cases Report

作　　者：于建华[1] 李守先[1] 李朝晖[1] 宋惠民[1] 苏润毅[1] 鲍继森[1] 

机构地区：[1]山东医科大学附属医院心外科,250012

出　　处：《心肺血管病杂志》1998年第2期117-118,共2页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：手术纠治三尖瓣下移畸形24例，死亡4例（16．67％）。合并畸形或病变有房、室间隔缺损、预激综合征、心包炎。行房化心室折叠术18例，三尖瓣替换术6例。作者认为随着手术方法、心肌保护和体外循环技术不断改进，手术指征应较过去放宽。手术治疗的关键是房化心室的折叠和三尖瓣关闭不全的纠正。术中注意避免损伤传导束和冠状血管。对功能右心室极小的重型三尖瓣下移畸形，术后易发生难以纠正的右心衰竭，死亡率高，以选择改良Fontan手术或全腔静脉与肺动脉连接术为宜。行三尖瓣替换的人工瓣膜以选择生物辩为宜。Surgical management of 24 cases of Ebstein's anomaly are reported. There were 4 deathes (16.67%). Coexisting cardiac malformation includs ASD, VSD, WPW syndrome and pericarditis. Eighteen cases were treated by plication of atrialized ventricular chamber and repair of tricuspid valve. The other 6 cases were treated by tricuspid valve replacment. The authors suggest that the surgical indication should be more flexible because of the improved surgical technique, myocardial protection and cardiopulmonary bypass. Care should be taken to avoid injury of atrioventricular node and coronary vessels. Modified Fontan procedure or total cavopulmonary connection should be undertaken if the functional right ventricle is too small to prevent refractable right ventricular failure which may be very difficult to manage. Xenograft is the suitable type of prosthesis for tricuspid valve replacement.

关 键 词：心脏 三尖瓣下移 三尖瓣置换 生物瓣膜 治疗 

分 类 号：R654.205[医药卫生—外科学]