小儿室间隔缺损合并主动脉瓣关闭不全：外科治疗效果和相关因素分析

收治室间隔缺损８８０例，６８例合并主动脉瓣关闭不全（７．７３％）。其中干下型室间隔缺损合并主动脉瓣关闭不全者４１例，膜周者２７例。５５例单纯行室间隔缺损修补术，１３例行室间隔缺损修补＋主动脉瓣成形术，无１例行主动脉瓣替换术。术后随访６月～１０ａ，无并发症，无近远期死亡，残余返流无１例较术前加重。多因素分析提示主动脉瓣关闭不全的程度、室间隔缺损的类型、瓣膜折叠的次数及术前心胸比率等对主动脉瓣成形术的疗效有着重要影响。

OPERATIVE EFFECTION AND CORELATED FACTORS OF AORTIC INSUFFICIENCY WITH VENTRICULAR SEPTAL DEFECT IN CHILDREN

PURPOSE To assess the operative effection and corelated factors of aortic insufficiency with ventricular septal defect in children.METHODS Sixty-eight patients with a ventricular septal defect and aortic insufficiency were retrospectively studied.Test and multiple regression analysis were used.RESULTS The ventricular septal defect was doubly committed subarterial in 41 patients and perimembranous in 27 patients.In 55 patients, closure of the ventricular septal defect were performed. Combined closure of the ventricular septal defect and aortic valvuloplasty were performed in 13 patients.No patient was received valvular replacement.The follow-up period was from 6 months to 10 years,and there were no complication and death.Postoperative residual insufficiency was no more severe than preoperative.CONCLUSIONS The present study suggests that a severe aortic insufficiency,perimembranous ventricular septal defect,multiple valvuloplasties,great cardiothoracic ratio were significant contributing factors for residual aortic insufficiency after aortic valvuloplasty.