21例先天性主动脉瓣下狭窄的外科治疗效果  

Surgical treatment of congenital subaortic stenosis

作　　者：方骏[1] 陈林[1] 肖颖彬[1] 

机构地区：[1]第三军医大学新桥医院心血管外科,重庆400037

出　　处：《第三军医大学学报》2004年第10期908-909,共2页Journal of Third Military Medical University

摘　　要：目的　回顾分析 2 1例先天性主动脉瓣下狭窄的手术治疗效果。方法　自 1999年 1月到 2 0 0 3年 6月手术治疗先天性主动脉瓣下狭窄 2 1例 ,其中隔膜型狭窄 12例 ,管型狭窄 9例。单纯狭窄隔膜切除术 12例 ,加行左室流出道心肌切除术 9例 ,同期手术矫治合并畸形 16例。结果　全组无手术死亡 ,无术后并发症 ,15例术后心脏杂音消失 ,其余患者术后心脏杂音均较术前明显减弱。术后随访 6个月至 2年 ,无明显临床症状 ,均正常学习、工作。复查心脏彩超提示左室流出道疏通满意 ,无瓣下狭窄复发。结论　先天性主动脉瓣下狭窄一经诊断宜早行手术治疗。掌握该病的病理解剖 ,手术操作仔细 。Objective To review retrospectively the clinical experience in surgical treatment of congenital subaortic stenosis in 21 cases. Methods A total of 21 cases of congenital subaortic stenosis, including 12 cases of diaphragmatic type of stenosis and 9 cases of cast constriction, underwent intracardiac surgery from January 1999 to June 2003. Simple resection of stenosis membrane was performed in 12 cases, simple resection of stenosis membrane plus resection of myocardium of left ventricle outflow tract in 9 cases, simple resection of stenosis membrane plus resection of myocardium of left ventricle outflow tract plus treatment of united cardiac monstrosity in 16 case. Results No operative death and complications were found in all patients. Disappearance of cardiac murmur was found in 15 cases and diminishment of cardiac murmur in the rest of the patients after operation. A follow up time for 6 months to 2 years revealed that there were no obvious clinical symptoms, and the surgical outcomes were satisfactory. The cardiac ultrasound suggested that the left ventricular outflow tract was fluent without recurrent constriction. Conclusion Early treatment of congenital subaortic stenosis should be conducted when the disease was diagnosed. Better knowledge of pathological anatomy, proper operation, and prevention of complications are essential.

关 键 词：先天性主动脉瓣下狭窄 外科治疗 

分 类 号：R542.52[医药卫生—心血管疾病] R654.1[医药卫生—内科学]