三尖瓣置换治疗Ebstein心脏畸形

目的 确定Ｅｂｓｔｅｉｎ畸形病人瓣膜转换术的手术适应证。方法 ３１例５～４６岁病人，其中１０例曾接受过修复术，全部手术均在全麻体体外循环下完成，４例心脏不停跳。分别转换生物瓣２枚，国产人工机械瓣膜１３枚和进口人工机械瓣６枚；同时对其他合并畸形进行修复。结果 体外循环转流时间５６～１３６ｍｉｎ，２７例主动脉阻断时间２９～８３ｍｉｎ。１２例病人手术结束时直视下测压，右心房压１５．８／７．５ｍｉｎＨｇ（

Tricuspid valve replacement for Ebstein's anomaly

Objective: To determine the surgical indications of tricuspid valve replacement for Ebstein's anomaly. Methods: Tricuspid valve replacement was performed in 31 patients. The age ranged 5 to 46 years. 10 cases previously tricuspid valve repair. The operation was carried out under general anesthesia and extracorporeal circulation including 4 patients on beating heart. The valve implanted included 2 biovalves, 13 China-made and 16 imported mechanical prosthesis valves. Others cardiac malformations were simutaneouly corrected. Results: The total time of aortic cross clamping was 29 to 83 minutes. CPB time was from 56 to 136 minutes. Cardiac pressure was measured in 12 patients at the end of operations. The right atrial pressure was 20.4/10.2 mmHg, right ventricle pressure was 26.3/5.3 mmHg and pulmonary artery pressure was 21.8/13.5 mmHg. There were 2 operative deaths. Conclusion: Tricuspid valves replacement should be considered in those patients with markedly enlarged tricuspid ring. The underdevelopment of septal leaflet downward displacement of anterior leaflet, and its attachment adhering to right ventricular wall or displaced into the right ventricle outflow tract.