【摘要】 目的分析单纯圆锥隔心室型室间隔缺损的病理解剖,探讨其外科纠治。方法回顾1999年4月到2005年4月手术纠治50例单纯圆锥隔心室型室间隔缺损病儿病历资料,其中后下缘肌性26例,主动脉瓣和三尖瓣纤维连接24例。结果术后无III度房室传导阻滞发生。2例因VSD前上缘残余分流(0·4cm,0·3cm),再次修补。11例有较明显的流出道肌束肥厚,完全或部分离断。2例体外循环停止后食管超声提示流出道肌束肥厚,压差分别为35mmHg、40mmHg,再次手术离断。随访5例有轻度右室流出道梗阻;三尖瓣中度反流1例,轻度5例,轻微5例。2例心包积液,1例术后出血。结论提出圆锥隔心室型VSD的定义,规范其病理解剖和外科纠治会进一步精确室间隔缺损的诊治。更多还原

【Abstract】 Objective To analyze the pathologic anatomy and surgical treatment of conoventricular septal defect. Methods Retrospectively reviewed fifty patients with conoventricular septal defect patients treated from April 1999 to April 2005. Results 26 patients had a muscular postero-inferior border ,24 patients had fibrous continuity between the leaflets of the aortic and tricuspid valve. No stage III° AVB occurred. 2 patients were reoperated cause of residual VSD (0.4cm, 0.3cm) in antero-superior border. 11 patients had obviously outlet muscular hypertrophy bundles which was divided completely or partly. TEE at end of operation showed ad outlet muscular hypertrophy bundles and pressure gradient was 35 mmHg, 40mmHg respectively in two patients,so reoperation were performed. Complications included mild right ventricle outlet obstruction (5 cases).Moderate triscupid valve regurgation (1 case),mild (5 cases),trivial (1 case).Pericardial effusion (2 cases),bleeding (1 case). Conclusion Better understanding the anatomy of conoventricular septal defect may well improves the result of surgery.更多还原