【摘要】 目的探讨三尖瓣下移畸形的手术方法及术后临床效果。方法三尖瓣下移畸形患者52例,行三尖瓣置换手术6例,行三尖瓣成形术46例,其中水平房化心室折叠三尖瓣成形术22例(加行De Vegar法成形术6例,Kay法成形术7例);行垂直房化心室折叠三尖瓣成形术24例(加行De Vegar法成形术13和Kay法成形术5例);应用Carpentier环成形6例;有8例患者加行上腔静脉与右肺动脉双向分流术。对术后患者进行随访并观察其预后情况。结果本组52例患者术后早期死亡2例(3.8%)。46例行三尖瓣成形术患者术后3个月复查超声心动图显示三尖瓣轻度反流27例,中度反流3例,无反流16例。6例三尖瓣置换术患者术后3个月复查超声心动图显示生物瓣膜开闭均良好。随访时间12~81个月。患者1年、3年、5年生存率分别为96.0%、88.0%、82.0%。结论根据术中探查发现畸形的类型及其严重程度选择最合适的手术方式对三尖瓣下移畸形患者预后意义重大。更多还原

【Abstract】 Objective To explore the surgical methods and postoperative clinical efficacy of Ebstein’s anomaly. Methods A total of 52 patients with Ebstein’s anomaly were enrolled,and 46 of them were implemented with tricuspid valve plasty,while other 6 patients were implemented with tricuspid valve replacement. Among 46 patients with tricuspid valve plasty,22 patients were performed horizontalfold atrialized right ventricle,of which 6 cases additionally underwent De Vegar’s annuloplasty,7 cases additionally underwent Kay’s annuloplasty,and 24 patients were performed with Vertical fold atrialized right ventricle,of which 13 cases additionally underwent De Vegar’s annuloplasty,and 5 cases additionally underwent Kay’s annuloplasty. Patients were followed-up,and prognosis was recorded. Results Two patients died in the early stage after operation( 3. 8%). Three months after operation,echocardiography showed that,of 46 patients with tricuspid valve plasty,27 cases were light tricuspid regurgitation,3 cases were moderate regurgitation,and16 cases were none-refluxation; by contrast,for 6 patients with tricuspid valve replacement,valve all worked well. Patients were followed-up for 12-81 months. The 1-,3-,5-year overall survival rate was 96. 0%,88. 0 %,and 82. 0%,respectively. Conclusion It has great prognostic significance to choose proper operation method for Ebstein’s anomaly patient on the basis of the type of deformity and severity in intraoperative exploration.更多还原