心室内隧道法治疗儿童右室双出口并主动脉瓣下室间隔缺损

目的　探讨右室双出口 (DORV)并主动脉瓣下室间隔缺损 (VSD)儿童采用心室内隧道法的手术效果。方法　对 9例DORV并主动脉瓣下VSD儿童采用心室内隧道法纠治 ,其中 5例有肺动脉瓣及瓣下狭窄 ,1例双腔右心室。体外循环下行心室内隧道法 ,经右心室切口用涤纶片修补VSD ,形成左心室至主动脉的内隧道 ,右心室与肺动脉相连。结果　 9例术后恢复均良好 ,超声心动图显示心室内隧道功能正常 ,无血流梗阻征象。结论　掌握好术式的适应证 ,心室内隧道法是纠治DORV并主动脉瓣下VSD的满意术式

Intraventricular tunnel procedure for double outlet right ventricle with subaortic ventricular septal defect in children

Objective To study the results of intraventricular tunnel procedure for double outlet right ventricle(DORV) with subaortic ventricular septal defect(VSD).Methods Nine children with DORV complicated with subaortic VSD underwent intraventricular tunnel procedure.Five of them had stenosis of pulmonary valve or subpulmonary stenosis,and one had double-chambered right ventricle. An intraventricular tunnel procedure was performed under cardiopulmonary bypass. Right ventriculotomy was made to repair the VSD with teflon patch. An internal tunnel was made between the left ventricle and the aorta.The right ventricle connected with the main pulmonary artery. Results All children survived and recovered finally. Echocardiography showed that the internal tunnel function was well.Conclusion With correct diagnosis and selection of procedure, intraventricular tunnel procedure is a satisfactory method for the treatment of DORV with subaortic VSD.