自体心包重建隔瓣在三尖瓣下移瓣膜成形术中的应用

目的 报告在三尖瓣下移瓣膜成形术中应用自体心包重建隔瓣的方法和疗效。方法 对15例超声心动图示三尖瓣中～重反流合并隔瓣发育不良的三尖瓣下移畸形的患者，应用自体心包重建发育不良的瓣叶，同时环缩扩大的瓣环及折叠房化心室，并修补合并的房间隔缺损或卵圆孔未闭。结果 15例患者无手术死亡，出院前超声检查显示三尖瓣无或少量反流。随访2个月至50个月，复查超声显示无反流9例，少量反流5例，中－重度反流1例, 心功能I级6例，心功能II级8例，心功能III级1例。结论 在三尖瓣下移瓣膜成形术中应用自体心包重建隔瓣可以获得满意的早期和中期疗效。

The application of intraoperative ultrasonography in the surgical treatment of patients with brain tumors

【Abstract】Objective To introduce the surgical techniques and outcome of rebuilding the septal leaflet of tricuspid valve with autologous pericardium in the valvuloplasty for Ebstein’s anomaly. Methods Between April 2001 and September 2007,15 consecutive patients with Ebstein’s anomaly showed moderate to severe regurgitation in tricuspid valve and dysplastic septal of tricuspid valve by echocardiography. All patients underwent the surgical corecction, involving tricuspid valvuloplasty utilizing autologous pericardium to rebuild the dysplastic septal leaflet, placation of the atrialized ventricular wall, tricuspid annuloplasty , and closure of atrial septal defect or patent foramen ovale. Results All patients were alive and echocardiography showed no or only trivil tricuspid valve regurgitation. Follow-up from 2 to 50 months, echocardiograpy results showed no regurgitation in 9, trivil regurgitation in 5, moderate to severe regurgitation in 1, improvement in NYHA functional level achieved to class one in 6, class two in 8, class three in 1. Conclusion Rebuilding the septal leaflet tricuspid valve with autologous pericardium in the valvuloplasty for Ebstein’s anomaly can obtained satisfactory early and mid-term results.