中老年先天性心脏病手术评价

目的：评价中老年先天性心脏病的手术疗效。方法：1989～1998年共手术治疗40岁以上的先心病患者117例，最大年龄62岁。其中单纯房缺69例，房缺合并瓣膜病变20例，动脉导管未闭12例，室缺15例，法乐氏四联症1例。所有患者均有不同程度胸闷、气急症状。除4例房缺行经导管闭合术外，其余患者均行外科手术到治。结果：手术死亡1例，死亡率0.8％。随访6～120个月，晚期死亡1例，原因不明。讨论：先心病患者，只要考虑到术后血流动力学有改善，手术纠治是必要和安全的，年龄因素不是手术的先决。

The Surgical Management of Congenital Heart Disease in Middle - aged and Elderly Patients

Objectives: To evaluate the operative results in middle - aged and elderly patients with Congenital heart Disease(CHD). Materials and Methodes: Between 1989 and 1998, 117 patients, aged from 40 to 62 years, with various categories ofCHD, including Atrial Septal Defects (ASD) in 69 cases, ASD associated with valvular diseases in 20, Patent Ductus Arteriosus(PDA) in 12, Ventericular Septal Defect (VSD) in 15 and Tetralogy of Fallot in 1. All patients suffered distress, dyspnea orother symptoms mildly or severely. Transcatheter ASD closure procedure was performed in four patients, whereas convention-al surgical treatrnent in others. Results: One patient died Postoperatvely with operative mortality of 0. 85 %. At follow - upranging from 6 to 120 months, there was one late death with unknown cause. Conclusion: The surgical treatment in middle -aged and elderly patlents w1th CHD is necessary and safe as considering the improvement of hemodynamics and thus the age ofpatient is only a factor for reference.