主动脉—左室隧道的外科治疗  

The surgical treatment of aortico left ventricular tunnel

作　　者：梅举[1] 汪曾炜[1] 张宝仁[1] 郝家骅[1] 武士英[1] 

机构地区：[1]第二军医大学长海医院胸心外科

出　　处：《中华胸心血管外科杂志》1999年第4期193-195,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的：报告４例主动脉—左室隧道（ＡＬＶＴ）的外科治疗经验。方法：３例ＡＬＶＴ的主动脉开口位于右主动脉窦上，１例位于左主动脉窦上。合并主动脉瓣关闭不全３例，房间隔缺损（ＡＳＤ）１例，肺动脉瓣狭窄（ＰＳ）１例，左冠状动脉—右房瘘１例。隧道主动脉开口应用补片修补１例，直接缝合３例。同期施行主动脉瓣替换３例，并处理ＡＳＤ、ＰＳ和冠状动脉—右房瘘各１例。结果：４例全部生存，无早期死亡及术后并发症。随访６～２９个月，无晚期死亡。ＮＹＨＡ心功能均为Ｉ级，超声心动图复查提示ＡＬＶＴ修补良好。结论：ＡＬＶＴ一经确诊，应立即手术修复，外科手术是唯一的治疗方法。Aim:To report the experience of surgical treatment of four patients with aortico left ventricular tunnel(ALVT).Methods:Four patients(one male,three female),age ranged from 5 to 31 years old,underwent surgical correction of aortico left ventricular tunnel.The aortic end of tunnel in three patients located above the right aortic sinus and one patient above left aortic sinus.The associated anomalies included aortic valve insufficiency in three patients,ASD in one,pulmonary stenosis(ps) in one and left coronary artery right atrium fistula in one.The surgical procedures were patch closure of aortic end of the tunnel(one patient) or direct suture closure(three patients).AVR was performed in three patients.ASD,PS and left coronary artery right atrium fistula were simultaneously corrected.Results:There were no operative death and no postoperative complications.During follow up period(6～29months),there were no late death.NYHA heart function was improved to class I in all four patients.Postoperative echocardiographic examination showed that ALVT were well repaired.Conclusion:ALVT should be treated surgically once the diagnosis is established.

关 键 词：先天性心脏病 ALVT 外科手术 治疗 

分 类 号：R541.105[医药卫生—心血管疾病] R654.2[医药卫生—内科学]