部分型房室间隔缺损外科治疗的临床总结

目的 总结部分型房室间隔缺损手术治疗的经验,以提高治疗效果.方法 回顾性分析32例部分型房室间隔缺损患者的治疗经过,以缝合瓣裂、Reed法环缩、运用成形环等方法矫正房室瓣关闭不全,分别采用Kirklin法和McGoon法修复原发房间隔缺损.结果 术后早期死亡1例,死亡率3.13％.McGoon法修补发生Ⅲ度房室传导阻滞2例,而Kirklin法则无一例发生.26例术后随访6个月至5年,术后3年内心功能均有改善.结论 根据二尖瓣畸形的病变解剖差异,选择个体化处理方法,采用Kirklin法修补原发孔型房间隔缺损更为安全可靠.

Clinical experience on surgical treatment of partial atrioventricular septal defect

Objective To summarize the experiences in surgical treatment of partial atrioventrcular septal defect, in order to improve its therapeutic effect. Methods A retrospective analysis of 32 cases of partial atrioven- tricular septal defect patients that received surgical treatment. We used suture, Reed method, annuloplasty ring and other methods to correct atrioventricular valve regurgitation. Kirklin method and McGoon method to repair primary atrial septal defect were respectively used. Results 1 patient died at early postoperative stage. The mortality was 3.13%. 2 patients that received McGoon method to operate were diagnosed I!I degree atioventricular block. Com- pared with using McGoon method, patients with operation in Kirklin method never developed the symptom. 26 cas- es were followed up from 6 months to 5 years, and found that all patients＇ cardiac function improved. Conclusion According to anatomical differences of the mitral valve deformity lesions, individual surgical method can be chosen. Compared with other methods, Kirklin method is more safe and reliable for repairing the primary atrial septal defect.