44例Ebstein畸形的外科治疗

目的：观察各种Ｅｂｓｔｅｉｎ畸形矫治手术的疗效以及手术前后左室功能的变化。方法：手术治疗４４例Ｅｂｓｔｅｉｎ病人，其中Ｈａｒｄｙ手术２８例，改良Ｄａｎｉｅｌｓｏｎ手术７例，Ｃａｒｐｅｎｔｉｅｒ手术２例，三尖瓣替换手术７例。对５例进行了压力－容积环测量，同时观察了左室室壁运动。

Surgical Treatment of Ebstein' s Anomaly in 44 Patients

Aim:To review the experience of surgical treatments of Ebstein's anomaly and to observe the preand postoperative changes of the left ventricular volume and function.Clinical material and method:Fortyfour operations for Ebstein's anomaly were performed from September 1984 to March 1997.There were 22 males and 22 females with a mean age of 17.7 years.Surgical procedures included Hardy's in 28 patients,Danielson's in 7 and Carpentier's in 2.7 patients underwent tricuspid valve replacement.Pressurevolume loops were measured in 5 cases and the motion of the left ventricular wall were observed at the mean time.Results:There were five hospital deaths with a postoperative mortality of 11.3%.33patients(75%) were followedup from 3 months to 7.5 years.27 cases(81.8%) recovered and heart function was improved to class I or II(NYHA).Pressurevolume loops were converted into endsystolic elastance.The motion of the left ventricular wall was nearly normal after surgery.Conclusion:Surgical procedures are selected according to various pathoanatomies.Longitudinal plication of the atrialized chamber can restore a large ventricular cavity and its function and improve left ventricular systolic function.