成人房间隔缺损手术疗效分析

目的探讨成人房间隔缺损(继发孔)及其合并症的外科治疗效果。方法应用体外循环技术行86例房缺手术封闭(补片修补74例、直接缝合12例)。并对有合并症者同时进行手术矫正,其中二尖瓣成形10例,二尖瓣置换6例,三尖瓣成形61例,右房迷宫8例。对上述患者的临床资料进行回顾性分析。结果全组患者无手术死亡。8例迷宫术后恢复为窦性心律。随访0.5￣1年,全组患者症状全部消失,心功能较术前提高Ⅰ￣Ⅱ级。结论没有右向左分流为主的成人房间隔缺损均应手术治疗,根据缺损类型及大小,采用补片修补或直接缝合,并对合并二尖瓣、三尖瓣病变及房颤给予相应处理,可提高手术效果。

Outcome of surgical treatment of atrial septal defect in adults: An analysis of 86 cases

Objective To investigate outcome of surgical treatment of isolated secundum atrial septal defect(ASD) and co-existing in adults.Methods The 86 patients underwent following procedure: 74 patients underwent with patch and 12 underwent direct suture closure respectively. The co-existing cardiac anomalys were treated at one time; 10 patients underwent mitral valve repair and three mitral valve replacement, 61 tricuspid valve repair, 8 right side maze procedure.above-mentioned obtained data were analysed retrospectively.Results All the patients survived after surgery.4 patients underwent right side maze procedure changed into sinus rhythm after operation.All the patients were followed- up from 6 months to one year. The symptoms all disappeared. All cardiac function were improved by Ⅰ-Ⅱ degree. Conclusion The adult patients who suffered from ASD but without left-to-right shunting would receive operation treatment. The patch or direct suture closure were taken according to their size and type of the defect in the procedure. The effects of surgey can be improved if deal with the co-existing anomalys of mitral valve and atrial fibrilation correspondencey.