心脏Ebstein畸形的手术治疗

Surgical treatment of Ebstien’s anomaly

  • 摘要: 目的: 总结10例Ebstein心脏畸形11次手术治疗的经验。方法: 男、女各5例,年龄5~40岁,平均18.8岁。根据临床症状、体格检查和超声心动图作出诊断。常规建立体外循环,手术行房化心室折叠10例,部分三尖瓣成形8例,三尖瓣替换3例,闭合房缺或卵圆孔未闭5例,部分右房壁切除3例。结果: 无手术死亡。随访0.3~9.8年,无远期死亡。心功能Ⅰ级9例。Ⅳ级1例,为重度三尖瓣关闭不全,已再手术,行三尖瓣替换,恢复良好,心功能Ⅱ级。结论: Ebstein心脏畸形患者应当尽早接受手术治疗。矫正心脏畸形要彻底,积极防治心律失常。

     

    Abstract: Objective: To review the experience in surgical treatment of 10 cases with Ebstien’s anomaly. Methods: Surgical procedures performed under the general cardiopulmonary bypass included plication of atrialized right ventricle in 10 cases, DeVega’s annuloplasty of tricuspid value in 8 cases, tricuspid valve replacement in 3 cases, closure of atrial septal defect or opening foramen ovale in 5 cases, partial excision of right atrial wall in 3 cases. Results: There was neither operative nor long time death during the 0.3~9.8 year follow up. Heart function of 9 patients in NYHA class I, one patient with heart function class IV received re operation because of the serious tricuspid regurgitation. Conclusion: The patients with Ebstein’s anomaly should be corrected thoroughly and arrhythmia prevented and treated actively during or post operation.

     

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