肺动脉下室间隔缺损伴主动脉瓣脱垂的外科治疗  

Surgical treatment of subpulmonary ventricular septal defect with aortic valve prolapse

作　　者：方刚[1] 李晋南[1] 郭德和[1] 苏金林[1] 李晓东[1] 

机构地区：[1]宁夏医学院附属医院胸心外科,宁夏银川750004

出　　处：《宁夏医学杂志》2000年第7期389-390,共2页Ningxia Medical Journal

摘　　要：目的　探讨对 2 6例肺动脉下室间隔缺损 (SPVSD)伴主动脉瓣脱垂的外科治疗。方法　室间隔缺损的修补均采用补片法 ,上缘 (即肺动脉瓣环下缘 )行带垫片双头针间断缝合 ;下缘用 4/0的Prolin线连续缝合。结果　 2 2例随访 2～ 5年并经彩色超声心动图检查 ,均无主动脉瓣脱垂或主动脉瓣关闭不全 (AI) ,2 6例患者无一例死亡。结论　肺动脉下室间隔缺损的主动脉瓣脱垂多为继发性改变 ,其发生原因是 :室间隔缺损导致的主动脉瓣环缺乏支撑 ;主动脉瓣下左向右分流时产生的负压 ;主动脉内舒张压使无支撑的主动脉瓣环向右室侧偏移。早期单纯的室间隔缺损修补 ,可预防继发性主动脉瓣脱垂的发生和发展 。Objectives Surgical treatment of subpulmonary ventricular septal defect(SPVSD) associated with aortic cusp prolapse(ACP) in 26 patients.Methods All of the ventricular septal defect was repaired with caron patches.The upper rim(that is lowerrim of pulmonary ring) was sutured by double needles interrupted suture.The lower rim was continuously sutured with 4/0 prolin.Results Of 26 patients,there was no death.Twenty-two patients followed for 2～5 years,they didn′t show aortic valve prolapse or aortic insufficiency under color ultrasound cardiography examination.Conclusions Aortic cusp prolapse is secondary to SPVSD.The pathogenesis are:Aortic ring lack support due to ventricular septal defect;the negative pressure produced by left to right shunt under aortic valve;diastolic pressure within the aorta lead the unsupportd aortic ring deviated to right ventricle.In order to prevent the production and progression of secondary aortic valve prolapse early simple ventricular septal defect repairment should be done.SPVSD should be corrected in infant.

关 键 词：室间陋缺损 主动脉瓣脱垂 并发症 外科手术 

分 类 号：R654.2[医药卫生—外科学]