室间隔缺损合并重度肺动脉高压的外科治疗

报道室间隔缺损(室缺)合并重度肺动脉高压11例,年龄5～18岁,术前均行心导管检查,Pp/Ps为0.75～0.93,平均为0.81,手术在体外循环下进行,全部经室切口修补,室缺2.0～2.5cm,无1例发生完全性房室传导阻滞。6例在术中置入Swan-Gaoz管。本组因呼衰及心低排综合征各死亡1例外余均好。强调了术前准备、术中心肌保护及加强术后管理是降低死亡率的有力措施。

SURGICAL TREATMENT OF VENTRICULAR SEPTAL DEFECT WITH SEVERE PULMONARY HYPERTENSION

Eleven cases of ventricular septal defect(VSD)with severe pulmonary hypertention are reported here.Age ranged from 5 to 18 years old(10 cases were less than 14 years old). Cardiac catheter made before the operation revealed Pp/Ps 0.75 to 0.93(av.0.81). Cardiopulmonary bypass operation was done.The ventricular defects were 2.0 to 2.5 cm in diameter and repaired through the right ventricle.There was no complete A-V block after operation.Swan-Ganz catheter was inserted in 6 cases during the operation.It serves as a guide to know well the sickness and to the use of medicine.All patients except two(died one from respiratory failure and the other died of low output syndrome)recovered uneventfully. We emphasize that well preoperative preparation,myocardial protection and postoperative management are necessary measures to reduce the operation mortality.