14岁及以下儿童三尖瓣置换的临床疗效分析  

Clinical outcome of tricuspid valve replacement in children aged no more than 14 years

作　　者：顿耀军 孙海宁[1] 闫军[1] 花中东[1] 李守军[1] DUN Yaojun;SUN Haining;YAN Jun;HUA Zhongdong;LI Shoujun(Department of Cardiovascular Surgery,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences,Beijing,100037,P.R.China)

机构地区：[1]中国医学科学院北京协和医学院,国家心血管病中心,阜外医院心血管外科,北京100037

出　　处：《中国胸心血管外科临床杂志》2020年第11期1298-1302,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的总结14岁及以下儿童三尖瓣置换术(tricuspid valve replacement,TVR)的临床特点及术后临床结果,并探讨瓣膜的选择。方法纳入2002年9月至2019年8月于阜外医院心血管外科行TVR的14例14岁及以下儿童,其中男9例、女5例,手术时平均年龄为(9.8±4.3)岁。结果8例患者行机械瓣置换,6例行生物瓣置换。平均体外循环时间为(170.3±109.8)min,平均主动脉阻断时间为(95.1±63.1)min。术后30 d内死亡率为21.4%(3/14),3例患者均死于严重低心排血量综合征。11例存活出院的患者均完成了随访,平均随访时间为34~199(100.1±57.4)个月。随访过程中,3例患者出现机械瓣功能障碍,其中2例行二次TVR。1例患者随访期间死亡。结论儿童TVR首选生物瓣,儿童TVR远期可能出现各种并发症,需密切随访并及时干预。Objective To summarize the clinical characteristics and outcome of tricuspid valve replacement(TVR)in children aged no more than 14 years,and to discuss the selection of prosthesis.Methods From September 2002 to August 2019,14 patients aged no more than 14 years who received TVR were included in our study.There were 9 males and 5 females,with a mean age of 9.8±4.3 years.Results Mechanical prosthesis was implanted in 8 patients,and bioprosthesis in 6 patients.The mean cardiopulmonary time and aortic-clamp time was 170.3±109.8 min and 95.1±63.1 min,respectively.The mortality within 30 days after surgery was 21.4%(3/14),and all 3 patients died of severe low cardiac output syndrome.Eleven patients were followed up for 34-199(100.1±57.4)months.During the follow-up,mechanical prosthesis dysfunction occurred in 3 patients,2 of whom received secondary TVR.One patient died during the follow-up.Conclusion The bioprosthesis is the first choice for TVR in children.Some long-term complications may occur after TVR,and close follow-up and timely intervention are needed.

关 键 词：三尖瓣置换 儿童 EBSTEIN畸形 治疗 外科 

分 类 号：R726.5[医药卫生—儿科]