鲁登巴赫综合征的外科治疗

目的 :总结鲁登巴赫综合征外科治疗经验。方法 :自 1992年 12月至 2 0 0 0年 6月手术治疗鲁登巴赫综合征 12例 ,其中房间隔缺损均为先天性 ,二尖瓣病变先天性 2例 ,风湿性 10例。单纯二尖瓣狭窄 8例 ,二尖瓣狭窄合并闭锁不全 4例。房缺直接缝合 8例 ,补片修补 4例。二尖瓣换瓣 9例 ,直视成形 3例。三尖瓣Devega成形 10例。结果 :围术期无死亡。 12例随访 6～ 90个月 ,1例二尖瓣成形术后 3年再次手术换瓣 ,余 11例恢复顺利。心功能恢复为Ⅰ级者 8例 ,Ⅱ级者 4例。结论 :鲁登巴赫综合征应尽早手术。正确选择处理二尖瓣病变手术方式 ,加强围术期处理 ,防治肺动脉高压危象和左心室功能衰竭是手术成功的关键

Surgical treatment of Lutembacher syndrome

Objective:This article is to review the experience of surgical treatment of Lutembacher syndrome.Methods:Twelve patients with Lutembacher syndrome were treated from December of 1992 to June of 2000.Clinical structure were as follows.ASD in 12 cases congenital mitral diseases in 2,rheumatic mitral diseases in 10;cases simple mitral stenosis 8 cases,mitral stenosis and insufficiency in 4 cases.Operations:ASD suture in 8 cases repairment in 4 cases MVR in 9 cases,MVP in 3 cases,tricuspid annuloplasty in 10 cases.Result:There was no death during perioperative period,the follow|up of 6～90 months showed that all were recovered except that one with MVP was replaced,the heart function are grade Ⅰ in 8 cases and grade Ⅱ in 4 cases.Conclusion:the cases with Lutembacher syndrome should be operated as early as possible,the success of operation is closely related to the mitral procedure,treatment of perioperative period,prevention from pulmonary hypertension crisis and left ventricular failure. [