摘要
目的报告自体心包片在三尖瓣成形术中的应用方法和疗效.方法应用新鲜自体心包片修复三尖瓣前瓣及腱索转移技术,同时准确测量三尖瓣隔瓣环长度(SL),按照1.75倍SL修剪经0.2%戊二醛处理的自体心包片用于精确环缩三尖瓣前瓣环及后瓣环,治疗2例Ebstein's畸形,同期行继发孔房间隔缺损修补手术1例,"缘对缘"三尖瓣成形手术1例;采用病变瓣叶切除,新鲜自体心包片修复瓣叶及人工腱索技术,手术治疗2例三尖瓣细菌性心内膜炎病变,同期行"缘对缘"三尖瓣成形术1例.结果4例患者无手术死亡.出院前心脏超声检查显示三尖瓣启闭良好,无反流或残留微量反流.随访4～24个月,微～少量反流3例,少～中量反流1例,无中～大量反流.心包片替代的三尖瓣前叶活动尚好,无增厚,无钙化.结论三尖瓣器质性病变应用自体心包片行瓣环成形术、瓣叶成形术可以取得优良的早期效果.
Objective Tointroduce the surgical techniques and outcome of autogeneous pericardium in the valvoplasty for organic tricuspid disease.Methods Anterior tricuspid leaflet plasty and tricuspid annuloplasty with autogenous pericardium which was pretreated in 0.2% glutorudehyde solution for 10 min were performed for Ebstein＇s anomaly in 2 cases,concomitant procedures included ASD repair in 1,edge-to-edge tricuspid valve plasty in 1.The diseased leaflet and the attched chordae were replaced respectively by pericardium and 5 ～0 Gore-tex suture in 2 cases with endocaditis,concomitant procedures included edge-to-edge tricuspid valve plasty in 1.Results There was no operative death.Echocardiogram showed good movement of leaflets and no regurgitation in all 4 patients.All patients were followed up for 4 to 24 months.Echocardiogram showed trivial regurgitation in 3 patients,moderate regurgitation in 1 patient,no severe regurgitation.Conclusion Tricuspid leaflet plasty and tricuspid annuloplasty with autogenous pericardium in treating localized tricuspid diseases can obtain satisfactory early-term results.
出处
《昆明医学院学报》
2009年第12期74-77,共4页
Journal of Kunming Medical College
