CAJ | 학술논문

目的总结由于外科修补或导管封堵室间隔缺损(VSD)所导致主动脉瓣反流的手术经验.方法 2011年2月到2014年2月,手术治疗7例外科修补或导管封堵室间隔缺损导致的主动脉瓣中度以上反流患儿,男4例,女3例,平均年龄7.2岁,平均体质量24.9 kg.膜周部VSD导管封堵术后损伤主动脉瓣2例;外科手术损伤主动脉瓣5例,其中3例为修补肺动脉瓣下VSD时损伤右冠瓣(2例瓣叶穿孑,1例瓣叶缺失),1例为修补膜周部VSD时损伤无冠瓣导致瓣叶穿孔,1例右室双出口修补主动脉瓣下VSD时缝合线牵拉主动脉瓣环导致对合不佳.主动脉瓣成形手术距VSD修补或封堵手术10天～1.5年,自体心包补片修补穿孔的瓣叶4例,自体心包补片行瓣叶延长2例,拆除VSD缝线重新修补VSD 1例.结果无手术死亡.随访2个月～3年,主动脉瓣成形效果满意,1例瓣叶缺失做瓣叶延长患儿主动脉瓣轻中度反流,余6例反流程度均为轻度以下.1例VSD封堵患儿合并双束支传导阻滞,心功能指数低于正常,余者心功能恢复正常.结论对于外科修补或导管封堵室间隔缺损所导致主动脉瓣反流,用自体心包补片做主动脉瓣成形术的效果满意.
목적 총결유우외과수보혹도관봉도실간격결손(VSD)소도치주동맥판반류적수술경험.방법 2011년2월도2014년2월,수술치료7예외과수보혹도관봉도실간격결손도치적주동맥판중도이상반류환인,남4례,녀3례,평균년령7.2세,평균체질량24.9 kg.막주부VSD도관봉도술후손상주동맥판2례;외과수술손상주동맥판5례,기중3례위수보폐동맥판하VSD시손상우관판(2례판협천혈,1례판협결실),1례위수보막주부VSD시손상무관판도치판협천공,1례우실쌍출구수보주동맥판하VSD시봉합선견랍주동맥판배도치대합불가.주동맥판성형수술거VSD수보혹봉도수술10천～1.5년,자체심포보편수보천공적판협4례,자체심포보편행판협연장2례,탁제VSD봉선중신수보VSD 1례.결과 무수술사망.수방2개월～3년,주동맥판성형효과만의,1례판협결실주판협연장환인주동맥판경중도반류,여6례반류정도균위경도이하.1례VSD봉도환인합병쌍속지전도조체,심공능지수저우정상,여자심공능회복정상.결론 대우외과수보혹도관봉도실간격결손소도치주동맥판반류,용자체심포보편주주동맥판성형술적효과만의.
Objective To review and summarize the experiences of aortic valveplasty gaused by surgical repair or transcatheter closure.Methods Seven patients with moderate or severe aortic valve insuffience underwent aortic valveplasty caused by surgical repair or transcatheter closure.Two patients underwent transcatheter closure for menbrame VSD previously.Five patients underwent surgical repair previously.Surgical procedure include patch repair of perforative aortic valve,valve leaflet extension and re-repair of VSD by remove previously suture line.Results No patient died,aortic valve insuffience was mild in six patients and moderate in one patient,six patients have good cardiac function.Conclusion Patch repair of perforative aortic valve and valve leaflet extension of lacerated leaflet have excellent result.