室间隔缺损合并主动脉瓣脱垂及瓦氏窦瘤破裂的外科治疗

目的总结室间隔缺损合并主动脉瓣脱垂及瓦氏窦瘤破裂的治疗体会.方法 118例室间隔缺损患者中合并主动脉瓣脱垂80例,主动脉瓣关闭不全为（＋～＋＋＋）;合并瓦氏窦瘤破裂37例;合并动脉导管未闭3例,三尖瓣关闭不全4例;合并亚急性细菌性心内膜炎7例,合并主动脉-右心室通道1例.结果本组无术后早期死亡,无室间隔缺损残余分流,复查部分病例仍有主动脉瓣关闭不全（＋、＋＋）,2例亚急性细菌性心内膜炎术后3个月再次行主动脉瓣置换术.结论室间隔缺损合并主动脉瓣脱垂及瓦氏窦瘤破裂及早手术治疗总体效果好.术中加强心肌保护、正确处理是治疗

Surgical treatment of ventricular septal defect with aortic valve prolapses and ruptured aortic sinus aneurysm

Objective To sum up the experience of surgical treatment of ventricular septal defect (VSD) with aortic valve prolapses and ruptured aortic sinus aneurysm.Methods In 118 cases of VSD,80 cases were complicated with aortic valve prolapses paortic value insufficiency(+)~(+++) and 37 with ruptured aortic sinus aneurysm,3 with patent ductus arteriosus(PDA),4 with tricuspid valve incompetence,7 with subacute bacterial endocarditis(SBE),and 1 with aortic-right ventricular channel.Results There was no postoperative early death or resident VSD shunt.Follow-up results showed mild aortic valve insufficiency (+)-(++) in some cases.2 cases with SBE received aortic valve replacement 3 months after operation.Conclusion Surgical treatment offers a satisfactory effect for ventricular septal defect with aortic valve prolapses and ruptured aortic sinus aneurysm.Early operation is recommended.Myocardial protection and proper treatment are important during operation.