双腔右心室95例的外科治疗

目的总结双腔右心室(DCRV)的诊断和外科治疗经验。方法回顾性分析近10年收治的DCRV95例，其中男56例，女39例，年龄1～48岁。单纯DCRV13例，合并其他心脏畸形82例，其中合并室间隔缺损56例。采用右房和右室漏斗部联合切口57例，单纯右房切口8例，单纯右室漏斗部切口30例。结果肌隔型61例，肌束型34例。全组无手术死亡。术前超声心动图误诊为VSD 15例，误诊为PS 3例，均于术中探查确诊。结论单纯DCRV少见，以合并VSD多见。多普勒超声心动图对诊断有较高价值，但也有较高的误诊和漏诊率。术中探查很重要，应常规探查三尖瓣和肺动脉瓣。采用右室切口更有利于右室流出道狭窄的彻底解除。

Surgical treatment of double-chambered right ventricle:a report of 95 cases

Objective To summarize the experience in diagnosis and surgical treatment of double-chambered right ventricle (DCRV). Methods From 1990 to 2001, 95 patients with DCRV received surgical correction, including 56 males and 39 females, with an age ranging from 1 to 48. 82 cases had other cardiac abnormalities, 56 of whom had ventricular septal defect (VSD). Right atrium incision was made in 8 patients, right ventricular infundibular incision in 30, and both right atriotomy and ventriculotomy in 57. Results Muscular ring was found in 61 patients, and muscular shelf in 34. No death occurred. Preoperatively, 15 patients and 3 patients were misdiagnosed by echocardiography as VSD and pulmonary stenosis, respectively. The diagnosis was corrected during operation. Conclusions DCRV was often found to be complicated with other cardiac disorders. Echocardiography was the main diagnotic method, but the misdiagnosis was not uncommon. So it was very important to make surgical exploration, especially on tricuspid valve and pulmonary valve during intraventricular operations. Right ventricular infundibular incision was convenient and dependable.