右室双腔并发室间隔缺损67例治疗分析

目的:探讨67例右室双腔并发室间隔缺损的治疗方法。方法:对67例右室双腔并发室间隔缺损进行根治手术,术中、术后测量其右心室-肺动脉压差。结果:全组手术死亡2例,手术死亡率3%。死亡原因:严重低心排血量综合征1例,发生室性心律失常1例。痊愈患者分别随访3～12个月,所有患者均无室间隔残余分流,右室-肺动脉压差小于20mmHg。结论:行右室双腔并发室间隔缺损手术患儿年龄应适当减小,虽然低心排血量综合征已不是先天性心脏病手术术后并发症和死亡的主要原因,但在该类手术中仍应引起重视。术中处理重点应为正确处理室间隔缺损和右室肥厚肌束。

Surgical treatment of double chamber right ventricular with ventricular septal defect

Objective:To summarize the experience of surgical treatment of double chamber right ventricular(DCRV) with ventricular septal defect(VSD).Methods:67 patients underwent corrective surgery of DCRV with VSD.Their right ventricle-pulmonary artery gradient during operation and postoperation were measured.Results:There were 2 operative death,the surgical mortality were 3%.The causes of death were serious low cardiac output syndrome(1 case) and ventricular arrhythmia(1 case).Follow up was extended 3~12 months in the recovered patients,and all of them had no residual VSD.Their right ventricle-pulmonary artery gradient was less than 20mmHg.Conclusion:The optimal time of surgical treatment of the patients should be earlier properly.At present the low cardiac output syndrome is not the key cause of postoperation complications and death,but it is very important in these operations.Proper management of VSD and the stenosis of right ventricular outflow tract should be focused during operation.