42例弗氏窦瘤的外科治疗及远期疗效

我院自 1984年 11月至 1998年 5月共收治弗氏窦瘤破裂 4 2例 ,男性 2 7例 ,女性 15例 ,年龄 8～57岁 ,平均 2 8.2岁。其中弗氏窦瘤破入邻近心腔形成心脏瘘者 37例 ,未破裂者 5例。合并畸形 :室间隔缺损 2 5例 (59.5% ) ,右室双腔心 3例 (71% ) ,卵圆孔未闭 1例 (2 .4 % )。同时并发主动脉瓣关闭不全 12例(2 8.6 % ) ,细菌性心内膜炎 2例 (4 .8% ) ,其中三尖瓣赘生物 1例 ,二尖瓣、主动脉瓣均有赘生物 1例 ,二尖瓣关闭不全 1例 (2 .4 % )。对窦瘤及合并畸形进行外科治疗 ,无围术期死亡。随访 6个月到 13年 ,平均 5 4年。6例失访 ,远期死亡 2例 ,再次手术 3例 ,完全性房室传导阻滞 1例 ,无痛性心肌缺血 1例 ,主动脉瓣中度关闭不全 1例 ,余 2 8例临床效果良好。本文就弗氏窦瘤及合并畸形的诊断及外科治疗进行讨论

Surgical Management and Late Outcome of Sinus of Valsalva Aneurysm in 42 cases

Between Nov,1984 and May,1997,42 patients presented with a ruptured in 37 cases or nonruptured in 5 cases sinus of Valsalva aneurysm.There were 27 males and 15 females,their age ranged from 8 to 57 years,with a mean age of 28.2 years.Associated with a ventricular septal defect in 25 cases(59.5%),a double chamber of right ventricular in 3 cases(7.1%),a permanent fossa ovalis in 1 case(2.4%),an aortic insufficiency in 12 cases( 28.6%) ,a history of endocarditis in 2 cases(4.8%),a mitral valve insufficiency in 1 cases(2.4%).Operative procedures included repair of sinus of Valsalva aneurysm and correction of associated malformations.There were no in hospital deaths.The survivors were followed up for 6 months to 13 years,with an average of 5.4 years.Late death occurred in 2 cases,6 cases were lost in the period of following up.There were reoperation occurred in 3 cases.The following late complications occurred:complete atrioventricular block in 1 case,no pain cardiac ischemia in 1 case and moderate aortic insufficiency in 1 case,the remaining 28 cases were satisfactory.