单向活瓣补片矫治先心间隔缺损合并重度肺动脉高压双向分流

目的探讨先心间隔缺损合并重度肺动脉高压双向分流的外科治疗。方法回顾20例患者的临床资料,单向活瓣补片矫治9例病人,常规补片矫治11例病人,术后彩色二维超声心动图及多普勒检测肺动脉压。结果常规补片矫治组术后死亡2例,活瓣补片矫治组痊愈。全组术前肺动脉压平均93.9±20.3mmHg,术后下降到65±29.4mmHg,5例病人回到医院随访,随访期3个月～3年,肺高压进一步下降。结论单向活瓣补片矫治先心间隔缺损合并重度肺动脉高压双向分流能有效降低围术期死亡率,短中期生存令人鼓舞。

Unidirectional valve patch for repair of cardiac septal defects and severe pulmonary hypertension with bi - directional shunt

Objective To evaiuate the surgical treatment of cardiac septal defects and severe pulmonary hypertension with bi-directional shunt.Methods 20 patients of cardiac septal defects with severe pulmonary hypertension and bi-directional shunt were corrected under extracorporcal circulation.The unidircctional valvc patch was used to close 11 paticns.The postoperative pulmonary artery pressure were observed with 2D-Echo.Results 2 patients died in the hospital after operation.Mean pulmonary artery pressure decreased from 93.9±20.3 mmHg to 65±29.4 mmHg.5 patients returned to hospital for follow-up.The follow-up period was 3 months to 3 years.The echocardiographic follow-up reported the further decreased of pulmonary artery pressure.Conclusion The uni-directional shunt path for repair of cardiac septal defects and severe PH with bi-directional shunt decreased the perioperative mortality.Short-and intermediate-term survivals are encouraging.