房室间隔缺损合并左室流出道狭窄的外科治疗单中心临床结果  

Surgical strategies of atrioventricular septal defect with left ventricular outflow tract stenosis:Clinical outcome of single center

作　　者：曹跃丰[1] 李磊[1] 苏俊武[1] 程沛[1] 范祥明[1] CAO Yuefeng;LI Lei;SU Junwu;CHENG Pei;FAN Xiangming(Center of Pediatric Heart,Beijing Anzhen Hospital,Capital Medical University,Beijing,100029,P.R.China)

机构地区：[1]首都医科大学附属北京安贞医院小儿心脏中心,北京100029

出　　处：《中国胸心血管外科临床杂志》2021年第9期1072-1075,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的探讨房室间隔缺损合并左室流出道狭窄的解剖特点与外科治疗策略。方法回顾性分析2008~2019年11例于我院行房室间隔缺损合并左室流出道狭窄外科手术患者的临床资料,包括初次和再次手术患者,其中男6例、女5例,中位年龄15.0(7.6,22.0)岁。结果完全型房室间隔缺损3例,部分型房室间隔缺损8例。狭窄原因包括3例瓣下隔膜,4例狭窄纤维环并瓣下隔膜,3例肥厚肌束,1例瓣架结构变形。初次手术患者5例,再次手术患者5例,第3次手术患者1例。无住院死亡病例。与术前相比,术后左室流出道流速显著降低[449.0(393.0,507.5)cm/s vs.212.0(183.0,253.5)cm/s,P<0.05]。结论房室间隔缺损合并左室流出道狭窄手术治疗效果满意,但需长期随访关注再狭窄问题。Objective To explore the anatomical characteristics and surgical strategies of atrioventricular septal defect(AVSD)with left ventricular outflow tract(LVOT)stenosis.Methods The clinical data of 11 AVSD patients with LVOT stenosis who underwent surgeries in our hospital from 2008 to 2019 were retrospectively analyzed,including 6 males and 5 females with a median age of 15.0(7.6-22.0)years.Results There were 3 patients of complete AVSD and 8 patients of partial AVSD.Subaortic stenosis resulted from discrete subaortic membrane in 3 patients,diffused subaortic membrane in 4 patients,hypertrophied muscle bundles in 3 patients and distorted valve frame in 1 patient.Among these patients,5 patients underwent LVOT stenosis and AVSD repairs simultaneously for the first time,5 patients underwent LVOT stenosis repair for the second time and 1 patient for the third time.No postoperative death occurred.The postoperative LVOT flow velocity decreased dramatically after LVOT stenosis repair compared with preoperative one[449.0(393.0,507.5)cm/s vs.212.0(183.0,253.5)cm/s,P<0.05].Conclusion Surgical results of AVSD combined with LVOT stenosis are satisfactory,but the restenosis should be paid attention to via long-term follow-up.

关 键 词：房室间隔缺损 左室流出道狭窄 外科治疗 

分 类 号：R654.2[医药卫生—外科学]