外科治疗主动脉瓣下狭窄的疗效分析

目的 探讨手术治疗主动脉瓣下狭窄的临床疗效.方法 1996年12月至2009年10月在我中心接受手术治疗的58例主动脉瓣下狭窄的患者,其中男性35 例,女性23 例;年龄1～49 (15.9±5.7)岁.局限型主动脉瓣下狭窄56 例(纤维隔膜型33 例、纤维肌隔型21 例),隧道型主动脉瓣下狭窄2 例.局限型行狭窄隔...

Analysis of clinical effect of surgical operation on subaortic stenosis

Objective To analyze the clinical effect of surgical operation on subaortic stenosis.Methods Fifty-eight patients with subaortic stenosis were treated surgically in our center from December,1996 to October,2009.The patients,35 male and 23 female,were 1 to 49 years old at operation,with a mean age of 15.9±5.7.Among the patients,56 had discrete subaortic stenosis and 2 had tunnel subaortic stenosis.All the 56 patients with discrete subaortic stenosis underwent stenosis membrane resection,among whom 12 also received left ventricular myotomy.Left ventricular outflow tract muscle resection was performed on all the patients with tunnel subaortic stenosis.In 56 patients,combined cardiovascular malformations were corrected at the same time.Results There were 3 perioperative deaths.The mean systolic left ventricle to aorta gradient was 6.9±4.8 mmHg,with a range of 3.5-28.2 mmHg,after operation.In the follow-ups conducted on 54 cases after 1 year,48 after 3 years,31 after 5 years,and 22 after 8 years,all patients were asymptomatic postoperatively,and no reoperation was needed.Conclusion Preoperative echocardiography and routine exploration of the root of aorta are important in the diagnosis of the subaortic stenosis with combined cardiovascular malformations.The key points of the operation are that the left ventricular outflow tract should be thoroughly unblocked and that no injury should be made to the mitral valve,aortic valve,and conduction bundle.