流出道室间隔缺损合并主动脉瓣关闭不全的外科处理

目的总结流出道室间隔缺损（VSD）合并主动脉瓣关闭不全（AI）的外科处理经验。方法回顾分析94例VSD合并AI的临床资料、VSD补片修补和主动脉瓣处理方法。结果无手术死亡，术后低心排6例（6．4％）。在主动脉瓣脱垂伴轻度AI60例中，出院时超声检查（UCG）14例仍有轻度AI，随访中2例加重需再次手术。在主动脉瓣成形术25例中，UCG提示23例主动脉瓣轻度返流，2例轻微返流，2～5年后3例返流加重。9例主动脉瓣置换术中1例术后1年死于感染性心内膜炎。结论流出道VSD伴有AI，应根据主动脉瓣病理改变而选择恰当的方法。

Experience of surgical treatment of outlet ventricular septal defect with aortic valve insufficiency

Objective To evaluate the surgical treatment of outlet ventricular septal defect(VSD) complicated with aortic valve infficiency(AI).Methods Between Jan.1977 and Oct.2007,94 cases of VSD plus AI underwent surgical operations.The surgical procedures included closure of VSD in all cases,aortic valvuloplasty in 25 cases,and aortic valvular replacement in 9 cases.Results There was no perioperative death and low cardiac output syndrome occurred in 6 cases(6.4%).There was still mild aortic valve regurgitation detected by Doppler echocardiography in 25 cases of valvuloplasty and in 3 cases regurgitation aggravated during the follow-up.Conclusion The methods dealing with the aortic valve should be individualized according to the morphology of the valve in every case.