单片法联合左侧房室瓣抬高技术治疗完全性房室间隔缺损  

Results of single-patch with elevation of the left-sided atrioventricular valve repair for complete atrioventricular septal defect

作　　者：孟维鑫[1] 张国伟[1] 徐磊[1] 刘宏宇[1] Meng Weixin;Zhang Guowei;Xu Lei;Liu Hongyu(Department of Cardiovascular Surgery,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院心脏大血管外科,150001

出　　处：《中华胸心血管外科杂志》2018年第12期721-723,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的回顾性分析单片法联合左侧房室瓣抬高技术治疗完全性房室间隔缺损(CAVSD)的效果及安全性。方法2012年4月至2017年12月,采用单片法联合左侧房室瓣抬高技术治疗14例CAVSD患儿,男2例,女12例;中位手术年龄12.5个月(11.7~63.0个月)。术后随访(3.27±2.02)年。术前肺动脉压力(PAP)(65.92±6.91)mmHg(1 mmHg=0.133 kPa)。经胸骨正中切口,手术采用传统单片法联合左侧房室瓣抬高技术。术后密切随访,定期复查超声心动图和心电图。结果术后PAP(62.97±17.29)mmHg;随访期间PAP(53.29±20.99)mmHg,与手术前、后PAP差异均有统计学意义。术后及随访期间左侧房室瓣反流和右侧房室瓣反流程度较术前显著减轻。随访期间无房室传导阻滞和二次手术。结论单片法联合左侧房室瓣抬高技术治疗CAVSD近期和中期效果满意,术后无严重的房室瓣关闭不全发生,具有良好的应用前景。ObjectiveTo analyze retrospectively the results of single-patch with elevation of the left-sided atrioventricular valve repair for complete atrioventricular septal defect(CAVSD) in therapeutic effects and safety.MethodsFourteen consecutive patients(2 males and 12 females) with CAVSD were enrolled in the study from April 2012 to December 2017. All patients underwent single-patch with the elevation of left-sided atrioventricular valve repair for CAVSD by regular sternotomy. The median age at operation was 12.5 months(range, 11.7 months to 63 months) and the duration of follow-up was(3.27±2.02) years. Echocardiography and electrocardiogram were used during follow-up according to the protocol.ResultsCompared with pulmonary arterial pressure(PAP) during pre- and post- operation(65.92±6.91 and 62.97±17.29) mmHg(1 mmHg=0.133 kPa), PAP(53.29±20.99) mmHg decreased significantly during follow-up period. There were significant difference during post-operation and follow-up for LAVVR and RAVVR. The extent of regurgitation of atrioventricular valve statistically decreased during follow-up period. None of patients suffered from atrioventricular block and reoperation during follow-up.Conclusion Single-patch with elevation of the left-sided atrioventricular valve repair for CAVSD yields good outcomes, without occurrence of severe LAVVR, during early and mid-term follow-up period.

关 键 词：完全性房室间隔缺损 单片法 左侧房室瓣抬高 房室瓣反流 

分 类 号：R726.5[医药卫生—儿科]