摘要
【目的】探讨婴幼儿室间隔缺损(VSD)合并重度肺动脉高压(PH)外科治疗的手术适应证、手术时机、手术技术及围术期的处理。【方法】46例VSD婴幼儿,均合并重度PH,合并卵圆孔未闭(PFO)及房间隔缺损(ASD)32例,2例合并动脉导管未闭(PDA)。主动脉瓣下VSD 30例,膜周部VSD16例。全部患儿均在中低温、中低流量体外循环下进行手术,VSD均采取补片修补,ASD和PDA予以直接缝合。【结果】死亡3例,手术病死率为2.9%,Ⅲ度房室传导阻滞1例,1例存在3 mm残余漏。所有患儿术后3个月至1年随访,生长发育好。【结论】合并重度PH的VSD患儿,尽早行手术治疗,并且手术是安全的。
[Objective]To investigate the indications, operation timing, surgical techniques and perioperative management of surgical therapy for ventricular septal defect（VSD） and mild or severe pulmonary hypertension in infants,. [Methods] All 46 consecutive infants with VSD were confirmed to be complicated with severe pulmonary hypertension. Among them, 32 cases were complicated with patent foramen ovale（PFO） and atrial septal defect（ASD）, 2 cases with patent ductus arteriosus（PDA）. There were 30 cases with subaortic VSD and 16 with perimembranous VSD. All operations were performed under cardiopulmonary bypass at moderate to low flow, moderate hypothermia and cold crystalloid cardioplegia. All VSD were patch repairs, ASD and PDA were direct suture. [Results] The hospital mortality was 2.9 %. There was one with Ⅲ°A-V block and one with residual shunt（3mm）. Follow-up was complete in all 43 survived cases for 3 months to 1 years, and all developed well. [Conclusion]Infants with VSD and severe pulmonary hypertension should be operated on as early as possible, and operations are safe.
出处
《医学临床研究》
CAS
2008年第8期1377-1379,共3页
Journal of Clinical Research
