三房心的诊断和外科治疗

目的总结14例小儿三房心合并其他心脏畸形的外科治疗经验。方法全组均在中度低温体外循环下进行手术,平均年龄(5.6±3.5)岁,单纯型1例,复杂型13例(完全型11例,非完全型3例)。采用右房-房间隔径路显露左心房纤维隔膜,仔细辨认其解剖关系,充分剪除纤维隔膜疏通左心房通道,保护好二尖瓣膜。采用自体心包补片尽量扩大左心房容积,同时彻底矫正合并的其他心脏畸形。结果无一例手术死亡,14例全部存活,随访5个月~5年,心功能正常。结论三房心手术治疗取得早期和晚期良好疗效,手术关键在于仔细辨认,彻底矫正合并畸形。

The diagnose and surgical management of cor triatriatum in children

Objective To evaluate the results of surgical management of cor triatriatum in children.Methods Form September 1990 through October 2005,14 patients aged from 1 year to 12 years(mean,(5.5) years) with cor triatriatum were treated in our institute.It presented as an isolated defect(typical,n=1) or in association with other congenital cardiac anomalies(atypical,n=13).All operations were carried out through the right atrium-septal approach.The fibrous septals between the proximal and distal chambers of left atria were completely excised without injure the mitral valve.The atrial septal defect was repaired with pericardial patch.Results There were no operative mortality.Cardiac function returned to normal level in 10 patients during followup of 5 months to 5 years.Conclusions The satisfactory results can be achieved in children with cor triatriatum by dedicated surgical management and correction of associated cardiac anomalies.