室上嵴上室间隔缺损的外科治疗

本文报道５６例室上嵴上室间隔缺损的外科治疗。男３４例，女２２例，年龄３～３９岁。１９例合并主动脉瓣叶脱垂、主动脉瓣关闭不全或佛氏窦瘤破裂。经右房切口修补室缺２例，右室漏斗切口４７例，肺动脉切９７例。直接修补缺损２６例，补片修补３０例。主动脉瓣成形术１例，主动脉瓣置换术５例。５４例全愈出院，死亡２例。作者认为室上嵴上空间隔缺损应尽早手术，以免并发主动脉瓣损害和佛氏窦瘤破裂；中度主动脉瓣关闭不全可行主动脉瓣成形术，采用肺动脉切口优于右室漏斗部切口。

Surgical Management of the Conal(Supracristal)Ventricular Septal Defect

This paper reported the surgical management of 56 cases of the supracristal ventricular septal defect. 34 patients were male and 22 female.Age ranged from 3 to 39 years.19patients had aortic valve prolapse,aortic insufficiency or ruptured aneurysm of the sinus of Valsalva.operative exposure was through the right atrium in two patients,the infundibulum of right ventricle in 47 cases and pulmonary artery in 7 cases.The ventricular septal defect was closed directly in 26 patients.Patch closure was used for 30 cases.One patients underwent aortic valaloplasty and five patients had aortic valve replacement.54patients survived and two died.The authers considered that supraristal ventricular septal defect should be closed as early as possible soas to prevent progressive aortic valve change and ruptured aneurysm of the sinus of valsalva;that aortic valvuloglasty may be performed in moderate aortic insufficiency;that operative exposure through the pulmonary artery incisiou is better than the infundibulum of right ventricle.