上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (9): 1254-.doi: 10.3969/j.issn.1674-8115.2011.09.009

• 论 著 • 上一篇    下一篇

儿童主动脉瓣整形术的临床疗效

郑景浩, 徐志伟, 刘锦纷, 苏肇伉, 丁文祥   

  1. 上海交通大学 医学院附属上海儿童医学中心心胸外科, 上海 200127
  • 出版日期:2011-09-28 发布日期:2011-09-27
  • 作者简介:郑景浩（1965—）, 男, 主任医师, 博士, 博士生导师；电子信箱: zjh210@yahoo.cn。
  • 基金资助:

    上海市市级医院新兴前沿技术联合攻关项目（SHDC12010112）

Clinical outcome of pediatric aortic valve repair

ZHENG Jing-hao, XU Zhi-wei, LIU Jin-fen, SU Zhao-kang, DING Wen-xiang   

  1. Department of Cardiovascular and Thoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
  • Online:2011-09-28 Published:2011-09-27
  • Supported by:

    Shanghai Municipal Hospitals Joint Project, SHDC12010112

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摘要：

目的 总结主动脉瓣整形术在小儿主动脉瓣疾病中的应用经验。方法 分析83例行主动脉瓣整形术患儿的临床资料。患儿年龄4个月～11岁，平均年龄（3.6±5.0）岁。术前均经超声评估，其中单纯主动脉瓣反流24例，单纯主动脉瓣狭窄26例，二者兼有33例。手术方法为瓣交界切开26例，游离边缘交界悬吊27例，三瓣化瓣缘延长15例，瓣叶切除12例，瓣窦心包扩大6例，瓣环整形2例，两种及以上方法50例。结果 随访3个月~3年，有2例患儿死亡，无一例需要长期服用抗凝药，2例行换瓣手术。结论 对主动脉瓣疾病患儿行主动脉瓣整形术尤其是主动脉瓣缘延长是可行的，早、中期效果良好，可避免再次手术和抗凝治疗；随访中再次手术可选择换瓣手术。

关键词: 主动脉瓣整形术, 主动脉瓣缘延长, 儿童

Abstract:

Objective To investigate the clinical application of aortic valve repair in pediatric aortic valve disease. Methods The clinical data of 83 children undergoing aortic valve repair were analysed. Patients aged between 4 months old and 11 years old, with the mean age of (3.6±5.0) years old. Patients were evaluated by ultrasound before operation, and single aortic insufficient was found in 24 patients, single aortic stenosis in 26 patients, and aortic insufficient combined with aortic stenosis in 33 patients. The repair techniques included commissurotomy (n=26), resuspension of commissures (n=27), pericardial patch cusp extension (n=15), raphe excision (n=12), cusp plication (n=6) and annuloplasty (n=2), and 50 patients required a combination of techniques. Results Patients were followed up for 3 months to 3 years. Two patients died, no patient was discharged with long-term treatment with anticoagulation drugs, and 2 patients underwent aortic valve replacement. Conclusion Aortic valve repair may yield favorable short-term and mid-term outcome in treatment of pediatric aortic valve disease, which can avoid reoperation and anticoagulation therapy. Aortic valve replacement can performed for reoperation during follow-up.

Key words: aortic valve repair, aortic cusp extension, children