Otero Coto E, Sogorb F, de la Sen M L, Muñoz C
Servicio de Cirugía Cardiovascular, Hospital de Alicante.
Rev Esp Cardiol. 1992 Nov;45(9):595-7.
We report successful treatment of pulmonary valve agenesia with pulmonary stenosis and ventricular septal defect by infundibular resection, patch-closure of the VSD and implantation of a cryopreserved pulmonary homograft. Cases with mild to moderate hypoplasia of the pulmonary annulus are particularly well suited for direct pulmonary homograft implantation, while cases with severe hypoplasia and high right ventricular pressure after correction may be better treated with aortic homografts. Some technical aspects of homograft implantation (doing first the proximal suture, preserving the normal configuration of the valvular sinuses and using the subvalvular homograft tissue to enlarge the right ventricular outflow tract) may prevent significant valvular incompetence.
我们报告了通过漏斗部切除术、室间隔缺损修补及植入冷冻保存的肺动脉同种异体移植物成功治疗合并肺动脉狭窄和室间隔缺损的肺动脉瓣发育不全的病例。肺动脉瓣环轻度至中度发育不全的病例尤其适合直接植入肺动脉同种异体移植物，而矫正后严重发育不全且右心室压力高的病例可能用主动脉同种异体移植物治疗效果更好。同种异体移植物植入的一些技术要点（先进行近端缝合、保留瓣膜窦的正常结构以及使用瓣下同种异体移植物组织扩大右心室流出道）可能预防明显的瓣膜关闭不全。
