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Surgical treatment of atrioventricular septal defect
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
- Issue:
- 3
- DOI:
- 10.3760/cma.j.issn.1008-6706.2004.03.005
- Key Word:
- 房室隔缺损;手术治疗
Abstract： 目的总结31例房室隔缺损(atrioventricular septal defect,AVSD)手术治疗经验.方法31例中部分型(PAVSD)11例,中间型(MAVSD)5例,完全型(CAVSD)15例.采用5-0聚丙烯线往返连续缝合的方法闭合左房室瓣大瓣裂缺.部分病例同时进行左房室瓣或右房室瓣成形术.采用新鲜自体心包片或涤纶片修补原发孔房间隔缺损,将冠状窦口隔入右房侧.CAVSD 15例中,11例按McGoon"单片法"修补,4例用"双片法"修补.结果PAVSD及MAVSD无手术死亡,1例CAVSD根治术后早期死于严重低心排,死亡率3.2%.术后随访左房室瓣中度返流1例,轻度返流4例.全组病人术后无Ⅲ°房室传导阻滞,左室流出道狭窄及房、室缺残余漏.结论PAVSD及MAVSD如无肺高压、严重左房室瓣返流及左室流出道狭窄,手术可在1～2岁进行,否则应尽早手术.而CAVSD由于大量左向右分流和房室瓣返流,大多数患儿6～12个月即出现肺血管阻塞性病变,应在肺血管病变发生前行根治术.
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