双动脉下室间隔缺损的超声心动图特点及手术指征

目的探讨不同年龄双动脉下室间隔缺损(VSD)患者术后主动脉瓣脱垂(AVP)和主动脉瓣反流(AR)的发生率。方法根据年龄将35例患者分为两组:A组为2岁前手术病例13例,B组为5岁后手术22例。参照超声心动图结果及手术所见,探讨疾病发展过程及手术结果。结果35例患者中,AVP发生率为65.7%。其中A组AVP的发生率为30.8%,AR的发生率为15.5%;B组AVP发生率为86.4%,AR的发生率为54.5%。8岁以上发生AVP14例(14/14,100%),AR11例(11/14,78.6%);13岁以上发生AVP+AR6例(6/6,100%)。B组术前及术后AR的发生率明显高于A组(P<0.01)。结论AVP及AR的发生率均随年龄增长而逐渐增加。

Echocardiographic characters and surgical indication of Doubly committed subarterial ventricular septal defect

Objective To evaluate the prevalence of aortic valve prolapse (AVP) and aortic regurgitation (AR) in patients with doubly committed subarterial ventricular septal defect at different ages and the influence of early operation on AR. Methods 35 cases at different ages were divided into 2 groups. Group A: 13 patients in whom surgery was performed at the first 2 years of life. Group B: 22 patients in whom surgery was performed between 5 and 18 years of age. Results AVP was present in 23 patients (65.7%) of 35 patients. In group A, the prevalence of AVP and AR was 30.8% and 15.5% respectively. In group B, the prevalence of AVP was 86.4% while the prevalence of AR was 54.5%; AR gradually increased during childhood and reached a prevalence of 100% in teenagers. Incidence of AR in group B is much higher than that in group A before and after operation. Conclusion The prevalence of AVP increased with age as did that of AR. AR generally happened after AVP. Early operation can prevent the occurrence and development of AR,in patients with doubly committed subarterial ventricular septal defect.